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The City of Monroe is an Equal Opportunity Employer and Provider.
• I agree to read, listen to and follow all safety instructions and procedures presented in conjunction with this
assignment and to use my best judgment based upon my physical and mental abilities at all times, and to
immediately terminate participation in this assignment or any other volunteer assignment I agree to undertake
if activities become too strenuous, difficult, or hazardous for me. I am physically and mentally capable of
participating in the Assignment described above without injuring myself in any manner.
• I agree to waive all liability of The City of Monroe, hold them harmless, indemnify them, discharge them,
covenant not to sue them, and reimburse them for any liability, claims, sums, costs, or other expenses on
my account that may be caused in whole or part by my participation with the assignment.
• I further agree that, despite this Release and Waiver of liability, Assumption of Risk and Indemnity
Agreement, if I or anyone on my behalf makes a claim against The City of Monroe, I will indemnify, save and
hold harmless The City of Monroe from any litigation expenses, attorneys’ fees, loss, liability, damage, or
costs that The City of Monroe may incur as a result of such action.
• If I use a personally owned vehicle in the course of my duties, I understand I am required to have automobile
liability insurance in accordance with Oregon law. I understand I MUST possess a valid driver’s license and
that I will immediately inform The City of Monroe if my driver’s license is suspended or revoked.
• I understand that I am included and covered by The City of Monroe’s workers’ compensation insurance
program during those times that I am working as a volunteer for The City of Monroe.
• I understand that a photographer may be present to photograph the activities at the assignment and that I
may be photographed while participating in the assignment. I agree that I will contact the photographer if I
do not wish to be photographed. I give The City of Monroe permission to use and publish photographs of
me, or in which I may be included.
I have read this Agreement, fully understand its terms, understand that I have given up substantial rights by
signing it, and have signed it freely and without any inducement or assurance of any nature.
REQUIRED FOR ALL MINORS:
PARENT OR GUARDIAN’S AUTHORIZATION FOR MEDICAL CARE AND CONSENT TO
AGREEMENT
I, , as parent or legal guardian hereby grant permission for
to do volunteer work for The City of Monroe. In the event of an emergency, accident, or illness, I authorize The
City of Monroe and its employees to administer emergency medical care to my child and/or, if deemed
necessary, to secure emergency medical services and incur expenses for which I will be responsible for
payment. My signature below hereby represents that I have read, understand, and consent to this agreement.
Signature: ___________________________________ Date: ____________________
Note: Complete a new form each year for volunteer service that continues into the next fiscal year,
when volunteering for a different activity, or when volunteer duties change.
