First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Cell Phone

I, (enter name), have voluntarily applied to assist Greyhound Adoption League of Texas, Inc. (hereinafter referred to as GALT) with any and all work associated with the care of greyhounds and greyhound mixes as referenced in the Position Descriptions(s) for my volunteer role(s), and/or as specified in the Volunteer Agreement I signed. By applying for and performing this volunteer work, I have shown my agreement to each item below:*

I am aware that this is a contract between me and GALT and that it waives legal rights that I may have now or in the future and releases GALT and others from claims for damages.*

I AM VOLUNTARILY PARTICIPATING IN THIS ACTIVITY WITH FULL KNOWLEDGE OF THE TASKS INVOLVED. I AGREE TO ACCEPT ANY AND ALL RISKS ASSOCIATED WITH MY PARTICIPATION, INCLUDING BUT NOT LIMITED TO INJURY AND ILLNESS.*

I understand there are risks and dangers associated with working with domesticated and/or stray dogs, including but not limited to, bites, scratches, zoonotic diseases (diseases transmitted from animals to humans), and allergic reactions. I also understand there may be risks involved with exposure to certain chemical cleaning products while performing my volunteer duties. I fully understand and accept those risks and dangers.*

I fully assume all the risks involved with my volunteer activities, and acknowledge that they are acceptable to me. I agree to use my best judgment in undertaking these activities. I also agree to follow the rules and safety instructions as given by GALT volunteers authorized to act in a supervisory capacity.*

I agree that I will not sue, prosecute, or in any way make a claim against GALT for injury to me or damage to my property resulting from the negligence or other acts, howsoever caused, by any employee, agent, volunteer or contractor of GALT or other people as a result of my volunteer duties.*

I fully and forever release and discharge GALT from any and all actions, causes of action, claims, liabilities, or demands I have or may have in the future, whether known or unknown, for injury, illness, death or damage arising out of or related in any way to my volunteer duties.*

I agree that GALT may use my name, and pictures, photographs, or video and/or sound recordings of me on television, on radio, on the Internet, in emails, and in stories, news articles, advertisements, or other written or digital materials. I agree that such uses may include education, advocacy, and fundraising. I consent to and authorize, in advance, such use and agree that GALT does not have to notify me of such use or provide me with other consideration for such use. I waive any rights of privacy and/or publicity I may have in connection with these uses. *

I understand that GALT suggests and highly recommends that any adult who has not had a tetanus immunization within 10 years should get a single dose of Tdap. (Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: tetanus, diphtheria, and pertussis (whooping cough). Td is a booster vaccine for tetanus and diphtheria. It does not protect against pertussis).*

I agree that the rights I am giving up and agreements I am making apply equally to me and to my heirs, successors, assigns, guardians and legal representatives. I agree that none of those individuals may make any claim or take any action that I could not make or take myself*

I agree that this Waiver and Release of Liability protects and is for the benefit of GALT and also for its affiliates, and their respective employees, officers, directors, consultants, interns, volunteers, licensees, and all others acting on their behalf. I also agree that I may not make any claim or take any action against any of those affiliates or individuals that I could not make or take against GALT itself.*

I intend to fully and voluntarily waive any rights I have as described in this Waiver and Release of Liability. To the extent that legal consideration is required for this Waiver and Release of Liability to be effective, I agree that I have received good, valuable and sufficient consideration by being permitted by GALT to provide volunteer service and to receive training and instruction.*

I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS AND ACCEPT AND SIGN IT OF MY OWN FREE WILL. If I am under 18 years of age at the time of registration, my parent or legal guardian has completely reviewed this Waiver and Release of Liability, understands and consents to its terms, and authorizes my participation.

By typing/entering my/our name(s) I/we affix my/our electronic signature(s) acknowledging that the information supplied herein is true and correct.*

Date*

If Volunteer is under 18 years of age, Parent/Guardian signature is also required.

Parent or Guardian

Parent/Guardian Signature

Date:

In case of emergency, I authorize GALT to notify the contacts listed below on my behalf. Please enter name, relationship and phone number.

Second emergency contact info - please enter name, relationship and phone number: