Volunteer Release:
By signing below, I understand that I represent the Lakeland, Winter Haven/Polk County Continuum of Care and that I am over the age of 18. I hereby agree to hold harmless and release the Lakeland, Winter Haven/Polk County Continuum of Care; its member organizations, their boards/trustees, employees, volunteers, count organizers; and other participants in the Florida Point-In-Time Count from any liability for any accident, illness, injury or death or any theft or loss of property arising from the participation as a Volunteer in the Point-In-Time Count, regardless of whether incurred as a result of negligence or other. I voluntarily assume these and any other risks in participating in the count and waive all claims and causes of action that may arise out of participation in the count.
I have agreed to serve as a volunteer for the Florida Point-In-Time Count. I understand that as a volunteer for the Point-In-Time Count it will be necessary for me to handle and process confidential information. I acknowledge that I will keep all information confidential while a volunteer and that it is my responsibility to keep this information confidential even after I end my volunteer duties for the Point-In-Time Count. I understand that I am not to disclose any identifying confidential information and/or records or to engage in casual or informal conversation identifying any individual involved in the count.
I have read and fully comprehend the information pertained in this form and agree to the terms of this release. By signing below, I acknowledge that it is my responsibility to comply with all relevant laws, policies, and regulations concerning access, use, maintenance and disclosure of information made available to me as a volunteer in the Point-In-Time Count.