Volunteer Registration and Waiver of Liability

Huntington National Bank Give Back Day
Thursday, August 24, 2017
The home of Ms. Deborah Joshua
1819 N Lotus, Chicago, IL 60639

You must complete this registration form in order to participate in the Give Back Day Project!

In consideration of the opportunity afforded me to participate on a voluntary basis with Rebuilding Together, Inc., (including its local affiliate, Rebuilding Together Metro Chicago) in the rehabilitation project(s) described above, I (including my successors, assignees, heirs, guardians and legal representatives) hereby waive any right of recovery or cause of action arising as a result of my participation, in whole or in part, on said project(s) from which any liability may or could accrue against Rebuilding Together, Inc., Rebuilding Together Metro Chicago, the City of Chicago, Huntington National Bank, Ms. Deborah Joshua, and their respective officers, directors, agents, vendors, employees, contractors, and staff collectively or individually. Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me, to others, or damage to my property (or the property of others), including damage to (or injuries arising out of) automobiles, vans, trucks, buses, or other modes of transportation to or from the Project site, sustained in connection with activities associated with (either in whole or in part or during) the Give Back Day Project.

I do hereby grant and convey unto Rebuilding Together and/or any person authorized by them all rights, title, and interest in any photographs, recordings, interview, videotapes, motion pictures or similar visual or auditory recordings made by Rebuilding Together during my activities with respect to the project, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Name *
Name
Daytime Phone *
Daytime Phone
Evening Phone
Evening Phone
My Skill Level: *
Acknowledgement *
BY CHECKING THE BOX BELOW, I VERIFY THAT I HAVE CAREFULLY READ THIS WAIVER AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AS DESCRIBED ABOVE AND I SIGN IT OF MY OWN FREE WILL. I CERTIFY THAT I AM EIGHTEEN YEARS OF AGE OR OLDER.