LEGAL NAME EXACTLY AS IT APPEARS ON YOUR PASSPORT

 
Address *
Address
Cell Phone *
Cell Phone
Birthday *
Birthday
Expiration Date *
Expiration Date
Emergency Contact Number (cell) *
Emergency Contact Number (cell)
*
I understand that participation in CWE volunteer activities involves certain risks, including, but not limited to, serious injury or death. I am voluntarily participating as a CWE volunteer with knowledge of the potential danger involved and I agree to accept and assume all risks of participation. In consideration of acceptance of my application and allowing me to serve as a volunteer to and on behalf of CWE, I, for myself, and my personal representatives, heirs, and assigns, hereby forever release, discharge, and hold harmless CWE and its officers, directors, employees, agents and their respective heirs, representatives, successors and assigns, and each of them (“Releasees”), from liability of any nature whatsoever, at law or in equity, including without limitation, serious bodily injury, personal injury, property damage, illness, or death. I understand and agree that the Releasees are not responsible for any injury or property damage arising out of my participation as a volunteer, even if caused by the ordinary negligence or otherwise of any Releasee. I hereby consent to first-aid treatment or other medical services rendered in connection with an emergency during my service as a volunteer with CWE and release, discharge, and hold harmless Releasees from any claim whatsoever which arises or may hereafter arise on account of any such first-aid treatment or other medical services. I expressly agree that this release and waiver is intended to be as broad and inclusive as permitted by the laws of the State of Florida and its validity, construction, and enforceability shall be governed by and interpreted in accordance with the laws of the State of Florida.
Date *
Date