KE EP AUG U S T A BE A U T I F U L |
A DI V I S I O N O F EN V I R O N M E N T A L SE R V I CE S
|
ED K ES H A AN D E R S O N
PR O G R A M M A N A G E R
535 Telfair Street, Suite 520
Augusta, GA 30901
www.keepaugustabeautiful.com
(706)-312-4125
Keepaugbeautifulvm@augustaga.gov
RELEASE, WAIVER, HOLD HARMLESS, & INDEMNITY AGREEMENT
IN CONSIDERATION OF THE VOLUNTEER being able to serve as a volunteer for the Augusta, Georgia Government
(Augusta) in any activity which includes participation in Keep Augusta Beautiful’ s Adopt-A-Spot program or any other
volunteer program created by Augusta for the maintenance, improvement or work in or upon its facilities or right of
way, or any other related activity (hereinafter, “Covered Volunteer Activities”), I,
__________________________________ , the undersigned Volunteer, or the undersigned guardian of a Volunteer, on
behalf of myself and any personal representatives, assigns, heirs or next of kin do hereby freely, willfully, and without
duress execute this Agreement under the following terms on this ________ day of ________________ , 20_____:
1. WAIVER, RELEASE AND INDEMNITY: I hereby release and forever discharge and hold harmless Augusta, its
elected officials, officers, employees, board members, and agents and their successors and assigns (hereinafter
“the Releasees”) from any and all liability and claims, demands, rights of action, or actions, of whatever kind of
nature, either in law or equity, which arise or many hereafter arise from the Covered Volunteer Activities. I
understand and acknowledge that the execution of this Release discharges and will discharge the Releasees
from any liability or claim that the Volunteer may have against Releasees with respect to any bodily injuries,
illnesses, death, or property damage and are not obligated in any way to provide financial assistance or other
assistance including but not limited to medical, health, or disability or liability insurance, in the event of injury,
illness, or death, and all volunteers are expected to have their own liability and medical insurance which covers
them during participation in all Covered Volunteer Activities. I agree to held harmless and indemnify Augusta
from any legal matter, lawsuit, or litigation, arising from this volunteer relationship.
2. MEDICAL TREATMENT: I do hereby further release and forever discharge the Releasees from any claim
whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in
connection with the Covered Volunteer Activities.
3. ASSUMPTION OF THE RISK: I recognize that the Covered Volunteer Activities may include but not be limited to,
intently hazardous activities such as picking up trash and debris along public road and streets, construction,
loading and unloading, and transportation to and from the work sites. I hereby expressly and specifically assume
the risk of injury or harm in these situations and release and discharge the Releasees from and waive any and all
liability for any injury, illness, death, or property damage resulting from Covered Volunteer Activities.
4. WAIVER OF RIGHTS TO IMAGES: I hereby waive and release in favor of Augusta any and all rights, title, or
interest in any and all photographic images and/or video or audio recordings of me made by Releasees during
the Covered Volunteer Activities. I release Augusta from any expectation of confidentiality for myself and any
minor children listed. I acknowledge that my participation in this Adopt-A-Spot program is voluntary and that
neither the minor children nor I will receive financial compensation.
5. ADULT SUPERVISION: I hereby acknowledge that if I am signing this Release on behalf of someone under the
age of fifteen, I will insure that they have adequate adult supervision throughout his or her participation in
Covered Volunteer Activities.
