Miracle League of Plymouth · VOLUNTEER WAIVER: Adults and Children

ALL VOLUNTEERS:

Name of Volunteer (if a minor is volunteering please put their name here)

*

First Name

Last Name

Email

*

Verify Email

*

Date of Birth

*

(mm/dd/yyyy)

Over 18?

*

Yes

No

School (if under 18)

Gender

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Mobile Phone

By providing this information you are giving MLP permission to text in case of cancellation or other urgent matters related to volunteering.

Family Section

If you have mulitiple children volunteering you may use one form for all of your children.

Please add additional children here

First Name

Last Name

Date of Birth

(mm/dd/yyyy)

Gender

Please add additional children here

First Name

Last Name

Date of Birth

(mm/dd/yyyy)

Gender

Please add additional children here

First Name

Last Name

Date of Birth

(mm/dd/yyyy)

Gender

Under 18 Parent Information Section

Parent/Guardian (if volunteer is under 18)

*

First Name

Last Name

Address (if different from minor volunteer)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email (parent/guardian)

*

Verify Email

*

Mobile Phone (parent/guardian)

By providing this information you are giving MLP permission to text in case of cancellation or other urgent matters related to volunteering.

In consideration for The Miracle League of Plymouth providing the opportunity for me and/or my child as identified in the signature section below (hereinafter “Volunteer”) to participate in officially sanctioned baseball games and related activities played at The Bilkie Family Field and elsewhere, including practice sessions, pre-game and post-game activities, as well as all other officially sanctioned activities of The Miracle League of Plymouth that take place at The Bilkie Family Field and elsewhere, including, but not limited to, the annual Easter Egg Hunt, Family Picnic, 4th of July Parade, Holiday Party and Trick or Treating (hereinafter “Miracle League Activities”),the Volunteer (with the consent of a parent/guardian, if under 18) does hereby release and agree to indemnify and hold harmless The Miracle League of Plymouth and its officers and directors from any and all claims for personal injury, death, property damage, or any type of claim or damage (including but not limited to attorney fees or litigation expenses) resulting from activities in connection with the Volunteer’s participation in Miracle League Activities or the participation of any family member or guest of the Volunteer.

The Volunteer (with the consent of a parent/guardian, if under 18) understands that there are certain risks and hazards involved in participating in Miracle League Activities that may result in injury or death, including, but not limited to, those hazards associated with weather conditions, playing conditions, equipment and other participants. The very nature of Miracle League Activities is hazardous and risky, including, but not limited to, the acts of pitching, throwing, fielding and catching of the ball, the swinging of the bat, running, jumping, stretching, sliding, diving, and collisions with other participants and with stationary objects, all of which can cause serious injury or death. The Volunteer (with the consent of a parent/guardian, if under 18) voluntarily elects to accept and assumes all risks and hazards incidental to such participation in Miracle League Activities and consents to receive first-aid and/or emergency care by qualified Emergency Medical Technician or physician or other person qualified to render medical assistance in the event the undersigned suffers an injury during Miracle League Activities.

The Volunteer (with the consent of a parent/guardian, if under 18) understands that there will be media and promotional coverage of Miracle League Activities; gives consent to publish the Volunteer’s name and picture for such purposes; and grants The Miracle League of Plymouth, its affiliates, franchises, advertising and promotional agencies, and their agents, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing the Volunteer’s name, voice, likeness or any other identifiable representation of the Volunteer and the Volunteer’s family members. These materials may appear in any form, style, color or medium whatsoever (including, without limitation, photographs, video tapes, films, sound recordings, software, drawings, prints, broadcast, internet and electronic media). The Volunteer (with the consent of a parent/guardian, if under 18) agrees that all material containing identifiable representation of the Volunteer (including without limitation, all negatives, plates, and masters of any photographs, files prints or tapes) shall be and remain the sole and exclusive property of The Miracle League of Plymouth. The Volunteer (with the consent of a parent/guardian, if under 18) hereby releases and forever discharges The Miracle League of Plymouth from any and all liability and damages relating to the Volunteer’s name, voice, likeness or any identifiable representation of the Volunteer, and waives any right the Volunteer may have to inspect or approve the finished materials or any part or element thereof that incorporates the Volunteer’s name, voice, likeness or any other identifiable representation of the Volunteer and the Volunteer’s family. The Volunteer (with the consent of a parent/guardian, if under 18) has agreed to the above in consideration of the opportunity given to the Volunteer by The Miracle League of Plymouth to appear in these materials.

This waiver will remain valid and in effect for a minor until they turn 18 unless future notification is made in writing to the Miracle League of Plymouth at 525 Farmer Street, Plymouth, MI 48170 to cancel said waiver.

Adult Volunteers Only: I hereby give my full consent and permission to The Miracle League of Plymouth to obtain information relating to my criminal history and any other applicable records through a third party and their agents. The records as received by the reporting agencies may include, but not limited to, arrest, conviction, social security verification and/or driving records as well as plea bargains, deferred adjudications, and delinquent conduct committed as a juvenile. I understand that this information will be used in part to determine my eligibility to participate in Miracle League Activities. I also understand that as long as I remain in such capacity here, the above mentioned record checks may be repeated at any time. I do hereby remise, release, and forever discharge and agree to indemnify The Miracle League of Plymouth and the provider of the background screening, each of their officers, directors, employees, volunteers and agents and hold them harmless from and against any and all causes and actions, including but not limited to: suits, liabilities, costs, debts, and sums of money, claims, and demands whatsoever (including claims for negligence, gross negligence, and/or strict liability) and any and all related attorney fees, court costs, and other expenses resulting from the investigation of my background in connection with my request to participate in Miracle League Activities. I understand that it is the intent of The Miracle League of Plymouth to deny participation to any person who has been convicted of a serious crime. I understand that any inappropriate and/or unacceptable conversation or conduct with a juvenile may be grounds for immediate dismissal.

This waiver will remain valid and in effect unless future notification is made in writing to the Miracle League of Plymouth at 525 Farmer Street, Plymouth, MI 48170 to cancel said waiver.

Adult Volunteers Only: Volunteer Certification. Have you ever been convicted of a crime (felony or misdemeanor) involving any of the following?:

*

Harm or threat of harm against a person or persons?

Yes

No

*

Sexual offenses (including pornography and “victimless” crimes)?

Yes

No

*

Drugs and/or other controlled substances within the last 10 years?

Yes

No

*

Cruelty to animals?

Yes

No

CERTIFICATION STATEMENT

I certify that the above statements are true and that the making of false statements may be considered sufficient cause for immediate dismissal upon discovery thereof. I understand, and agree, that any misleading information or omission of information may be cause for dismissal.

*

Volunteer Consent (Parent/Guardian if under 18) I consent that the above information is correct to the best of my knowledge.

Yes

No

(Parent/Guardian if Under 18) I give authorization for my child (ren) to participate in Miracle League Activities, and do hereby consent to all terms above on behalf of my child (ren).

Yes

No