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2019 Waiver Form

Please read carefully. This is a legal document.

The undersigned individual (hereafter referred to using “I”, “me”, “my”, “myself”, or “Volunteer”) wishes to work as a volunteer of Shalom Farms, Inc., a nonprofit organization (“Shalom Farms”). Volunteer (and Parent/Legal Guardian) understands that volunteering for Shalom Farms will include performing physical labor, handling food products, working with various tools and equipment, planting and harvesting crops, weeding or preparing the fields, and any other tasks and activities incidental or related to the work of Shalom Farms (the “Volunteer Activities”). Participation in the Volunteer Activities involves certain risks, including, but not limited to, serious injury, and I am voluntarily participating in the Volunteer Activities with knowledge of the potential danger involved. I understand that I will be trained in proper and hygienic harvesting and packing procedures, and agree to always abide by these procedures when doing these activities on the farm.

 On behalf of myself and my family, guardians, estate, beneficiaries, heirs, successors and assigns, I (and Parent/Legal Guardian of Volunteer if Volunteer is under age 18) hereby release, discharge and forever hold harmless Shalom Farms and its employees (collectively, the “Organization”) from all present and future claims or demands for property damage, personal injury, wrongful death and any other liability of whatever kind that may arise as a result of my participation in the Volunteer Activities. I also agree to indemnify and hold harmless the Organization for all claims arising out of or relating to my participation in the Volunteer Activities. I understand and agree that the Organization is not responsible for any injury or damage arising out of the Volunteer Activities, including any injury or damage alleged to have arisen out of negligence by the Organization.

 I have disclosed any and all allergies or relevant medical conditions to the Organization on the Volunteer Information Form. I agree that Shalom Farms is not responsible for administering medical treatment of any kind.

 I hereby irrevocably grant and assign to the Organization all right, title and interest in and to any and all photographic images and audio or video recordings of me made by the Organization during the Volunteer Activities.

 I understand that this waiver and release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Virginia, and that it shall be governed by and interpreted in accordance with the laws of the Commonwealth of Virginia. I agree that if any portion of this waiver and release is invalid, the remainder will continue in full legal force and effect.

 I am the Volunteer or the Parent/Legal Guardian of the Volunteer. I have read and understood this document, and I am freely and voluntarily, and without any pressure or duress, completing this electronic waiver and release. I am of legal age.

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Contact Information
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First Name
Last Name

If you're volunteering as part of a group, please write the group, school or organization name here.
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Address Line 1
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State/Province
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Please list any allergies or other relevant medical information
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First Name
Last Name
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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We send out a once-monthly e-newsletter. We will never sell or share your personal information.