I acknowledge that I am a participant with San Francisco Public Works or SFMTA Potrero Division
via San Francisco Municipal Transportation Agency's Community Service Program. I desire to participate in volunteer "activities" that my involve physical/manual labor in inclement weather.
Physical Activities may include:
- Standing prolonged periods, twisting, bending, kneeling, pulling, lifting heavy objects, handling of non-hazardous/hazardous waste
Washing buses, sweeping facility or dumping trash. I recognize that there may be risks or hazards directly or inherently involved in this activity. The above-mentioned activities may expose me to certain unforeseeable risks of damage and/or bodily injury, including serious bodily injury, where I may need to be hospitalized. With full knowledge of the facts and circumstances surrounding this activity, I voluntarily undertake this duty and assume all responsibility and risk arising from my participation in this activity. Participation in this activity is NOT covered by worker's compensation, and that in the event of an injury I will not be eligible to file a worker's compensation claim. I recognize that should I incur a physical injury as a result of my participation, my health insurance coverage will be my resort for covering any cost related to injury.
I assure San Francisco Public Works or SFMTA Potrero Division that I have no health-related reasons or problems, including but not limited to emotional sensitivities, that would preclude or restrict my participation in this activity or that could be aggravated by my participation.
I hereby release San Francisco Public Works and SFMTA Potrero Division from any and all liability arising out of my participation in the above mentioned activities and hereby waive my rights herein to assert any claim(s) for damages, bodily injury or serious bodily injury to the fullest extent allowed by law. I further agree that I will hold harmless JBR Partners, Inc. against any and all claim(s) for damages, bodily injury or serious bodily injury arising out of or in connection with my participation in the above mentioned activities whether cause by negligence or otherwise.
I, the PARTICIPANT, affirm that:
- I have read and do presently understand the meaning, nature, and consequences of consenting to the terms and conditions of this Release and Waiver of Liability ("Release");
- I sign this Release in full recognition and appreciation of the risks of the above indicated activity;
- I am fully competent to sign this Release;
- I agree to the terms and conditions contained in this Release, and
- Therefore, I execute this Release for full, adequate, and complete consideration, fully intending for myself, the PARTICIPANT'S family, estate, heirs, administrators, personal representatives, or assigns to be bound by the terms of this Release.
THIS IS A RELEASE OF LEGAL RIGHTS, READ BEFORE CHECKING THE BOX BELOW.