Help for First Name
Enter in your First Name
Help for Last Name
Enter in your Last Name
Help for Street Address, City, State, and Zip Code
Enter in your street address, city, state, and zip code.
Help for Phone Number
Enter in your phone number
Help for Email Address
Enter in your email address
Help for Birth Date
Enter in your Birth Date
Help for Who is your Emergency Contact? (name & phone number)
Please provide name & phone number of emergency contact
Help for Availability: Monday – Sunday – Mornings, Afternoons & Evenings
Enter day and times that you are available
Help for Do you have any Special Skills?
Enter any special skills you may have.
Help for If you answered yes to the above question, please explain:
If you have a felony please explain
Help for Please list your previous employers with supervisor's name.
Please provide your previous employer and supervisor's name.
Help for Please list three references with contact number
List three references and phone numbers.
Help for Waiver and Release: I_________________________, release and forever discharge and hold harmless Hazel Park Schools (HPS) and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Nonprofit. I understand and acknowledge that this Release discharges HPS from any liability or claim that Imay have against Nonprofit with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Nonprofit or occurring while I am providing volunteer services. 2. Insurance: Further I understand that Nonprofit does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of HPS beyond what may be offered freely by HPS in the event of injury or medical expenses incurred by me. 3. Medical Treatment: I hereby Release and forever discharge HPS from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with HPS. 4. Assumption of Risk: I understand that the services I provide to HPS may include activities that may be hazardous to me including, but not limited to Coronavirus involving inherently dangerous activities. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and Release HPS from all liability. 5. Photographic Release: I grant and convey to HPS all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by HPS in connection with my providing volunteer services to Nonprofit. 6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Michigan and that this Release shall be governed by and interpreted in accordance with the laws of the State of Michigan. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected. By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily. Please type your name.
Enter your Legal Name.