Acknowledgement of Volunteer Relationship and
Release of Liability and Indemnification
I agree to donate my services for public service, religious or humanitarian reasons.
My participation in this volunteer position is not in exchange for any consideration, including
without limitation, pay, medical or other benefits, or the promise of future employment. I
acknowledge that in exchange for my service as a volunteer, I have neither been promised, nor
do I expect to receive, any payment or other consideration.
I acknowledge and understand that as a Santa Clara University (“University”) volunteer I am
not a University employee. I understand and agree that either the University or I may end my
volunteer relationship at any time, for any reason, with or without advance notice.
I hereby certify that I do not suffer from any physical infirmity or chronic illness which would
affect my ability to safely volunteer at the University. I also understand that Santa Clara
University does not provide health or accident insurance coverage for any volunteers.
I hereby agree to waive, release and discharge any and all claims for damages, death, illness,
personal injury or property damage which I may have against Santa Clara University, its
Trustees, directors, officers, employees, students and agents as a result of my volunteering at
Santa Clara University.
I agree to defend, indemnify, and hold harmless Santa Clara University, its Trustees, directors,
officers, employees, students and agents from any and all liability, as described above, that may
occur as a result of my volunteering, but not to the extent that such liability is due to the sole
negligence or willful misconduct of Santa Clara University.
I HAVE READ THIS CONSENT FORM AND UNDERSTAND ITS TERMS. I EXECUTE THIS
CONSENT VOLUNTARILY WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE. BY SIGNING
THIS CONSENT FORM I ATTEST TO THE FACT THAT I AM EIGHTEEN YEARS OF AGES OR
OLDER.
_______________________
Date
______________________________________________ ______________________________________
Volunteer (please print name) Volunteer’s Signature
________________________________________________ _____________________________________
Received by (Department Representative) Date
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