First Name_________________________Last Name____________________

The Undersigned __________________________ (print name), does hereby acknowledge and assumes the risk of participation in any and all activities of Almost Home Foundation at any location Almost Home Foundation activities take place. 

He/she does hereby acknowledge that he/she will release Almost Home Foundation, its officers, staff members, volunteers, advisors, property owners, and/or agents in any location where Almost Home Foundation activities are conducted, of and from all claims which may hereafter develop or accrue to them on account of injury, loss or damage, which may be suffered by said person/ minor or to any property, because of any matter, thing, or condition, negligence or default whatsoever, and they hereby assume and accept the full risk and danger of any hurt, injury or damage which may occur through or by reason of any matter, thing or condition, negligence or default, or any person or persons whatsoever.

It is further agreed and understood that he/she shall maintain in full force and effect, a policy of insurance covering medical treatment and all related costs in the event of an injury to him/her as a result of his/her participation in any and all activities of Almost Home Foundation as aforesaid. He/she also agrees that if he/she does not maintain in full force and effect a policy of insurance, he/she is still liable for medical treatment and all related costs in the event of an injury to him/her as a result of his/her participation in any and all activities involving Almost Home Foundation as aforesaid.

The person executing this release acknowledges that there is a valid consideration to executing this release.

The invalidity of any statement or waiver of rights above under local, state, or federal law does not invalidate any other statement or waiver of rights above.

Dated this _______ day of ______________________ (year)______________

Signature of Participant _______________________Date of Birth__________

 (The following applies to volunteers under the age of 18)

Signature of Parent or Legal Guardian_________________________________

I, ______________________________ (Name of Parent or Guardian), agree to have my minor child___________________________________ (name of child) participate in any activity of Almost Home Foundation, and acknowledge that I am fully and totally responsible for the above child at all times while he/she is participating in any activity with Almost Home Foundation.

___________________________________________(Signature of Parent or Legal Guardian) Date__________________________________