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* 1. How can we reach you? (Please include your first and last name.)

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* 2. We are looking for volunteers for multiple outlets. Choose what you would be interested in volunteering for. Click all that you would be interested in.

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* 3. What is your availability? What are the best times/days for you to help?

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* 4. VOLUNTEER WAIVER & RELEASE OF PERSONAL LIABILITY:
In the event, I, or a registered family member, suffer any illness or accident requiring emergency hospitalization, medication, or other medical assistance while participating in a volunteer event, permission is given for any medical treatment which is deemed necessary and reasonable under the circumstances. I fully understand and comprehend that reasonable care will be exercised by the adult staff for this volunteer event to protect the safety of those involved. I understand that the field supervisor’s instructions must be followed at all times, and that I am responsible for any damages caused to property by me/my family members not following these instructions. I do not hold the board, members, or employees of Choosing a Quality Life (C-QuL) or Napier Heights Food Co-op (NHFC) or any volunteers liable for injury, bodily harm, accidents, or death of myself/my child during events sponsored by C-QuL or NHFC. Neither will I hold the person(s) who owns and/or operates the property from which we volunteer, liable for accidents, injury, or death during C-QuL or NHFC events.

PHOTO/VIDEO USAGE WAIVER INFORMATION:
Photos, videos, and other images in which I, or a registered family member, appear that are taken during events may be used by C-QuL or NHFC for news coverage, social media, newsletters, reports, displays, and for other print, broadcast, web, or electronic news or promotional purposes.

COVID-19 AMENDMENT WAIVER INFORMATION:
While we encourage staff and attendees to take everyday preventative actions to help prevent the spread of any illness, including COVID-19, we must acknowledge there still exists a potential risk of encountering an individual who is COVID-positive and asymptomatic. You can review the research available online by copying and pasting this web address: https://covid19risk.biosci.gatech.edu/. These preventative measures include but are not limited to, Cleaning hands often. Avoiding close contact with people who are sick Staying home when you are sick. Maintaining groups of 10 people or less Using a cloth face-covering in public Maintaining a distance of at least six feet from other people in social Situations

SELF-DISCLOSURE:
In addition to the precautions above, I attest that: I am not experiencing any symptoms of illness such as fever, dry cough, shortness of breath, chills, muscle pain, sore throat, or a new loss of taste. I have not traveled internationally within the last 14 days. To the best of my knowledge, I have not been exposed to someone with a suspected or confirmed case of COVID-19. I myself have not been diagnosed with COVID-19 and am not awaiting test results to prove/disprove that fact. If my responses to any of the above statements change; if I believe I have been exposed to COVID-19; or if I am simply feeling unwell, I agree to not attend the volunteer shift or event. Research has shown these measures greatly reduce the risk of transmission of illnesses like COVID-19. However, the risk of encountering someone who is COVID-positive, even in small groups of 10 or less, has reached statistically significant levels and C-QuL or NHFC wants to be sure you are fully aware of this research. In consideration of this information, signing this waiver and/or participation in any C-QuL or NHFC-related activities constitutes an agreement to the release of liability. Your electronic signature of the disclaimer/waiver, completely releases C-QuL or NHFC, its volunteers, farmers, donors, recipients, and any other partners of any potential or perceived liability in connection with the now-disclosed potential encounter with a COVID-positive person. Any participation in C-QuL or NHFC-related activities is, in effect, active consent to this release of liability for C-QuL or NHFC and any of its partners.

TO AGREE TO THE WAIVER TERMS for yourself or for a minor of which you are the legal guardian, sign here. (Typing

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