Identified Risks of Participation
This form should be used in conjunction with the Volunteer Designation Form.
Volunteer’s Full Name (PRINT):
Volunteer Assignment:
Assignment Date(s) and Time(s):
This list of potential risks related to this activity or event is intended to assist
participants in evaluating the risks of participation and understanding their assumption
of those risks through voluntary participation. Additional risks, foreseen and
unforeseen, common and uncommon, may also exist and are also assumed through
voluntary participation in this activity or event.
1. Bodily injury up to including death
2. Property damage
3. Temporary and Permanent disability
Volunteer’s Signature:
Date Signed:
Attach this form to the Volunteer Designation form and send to Risk Management.
C.I. Risk Management Rev. 8/2013
Identified Risks of Participation
