Please check out the Bread of Life Mission Liability & Release form.

1. Volunteer Agreement and Release from Liability
In signing this form, I understand and agree to the following terms and conditions related to
volunteering my services to Bread of Life Mission.
Name:
I recognize that, as a volunteer I represent the above organization to the public. I accept the
responsibility for this status and will conduct myself in a professional manner.
I agree to maintain the confidentiality of all volunteers, clients, and donors about whom I have personal
and identifying information. I will not disclose the names of and personal details about guests and
residents, nor details that are revealed to me, nor information I may hear about guests, residents, donors,
staff members, volunteers or other individuals during my service with Bread of Life Mission.
I agree to honor the commitment length and frequency of service that I make to Bread of Life Mission. I
agree to provide as much advance notice as is possible in the event that I will be absent from my volunteer
shift. I agree to update my personal and emergency information as changes occur.
I understand that some volunteer activities may pose the risk of serious injury or even death to me and
involve the use of or exposure to tools, electrical, and other equipment that may cause harm. I understand
and acknowledge that injuries may result not only from my own actions, but also may be caused by the
negligence or actions of other volunteers, staff, clients and other agents of Bread of Life Mission. I
voluntarily assume all of the risks of and accept personal responsibility for all damages and losses which
may result during my activities as a volunteer with Bread of Life Mission. I hereby release, waive,
discharge and covenant not to sue Bread of Life Mission and any of its members, principals, officers,
directors, employees, agents, representatives, successors and assigns to hold them harmless from and as
to any and all liability, losses, damages, or costs of any kind or of any nature that are caused by, result
from, or are related in any way to Bread of Life Mission and my volunteer activities.
I understand that if I bring any minor children with me while performing volunteer activities, I am solely
responsible for supervising and ensuring their safety. I agree to indemnify and hold Bread of Life Mission and
its members, principals, officers, directors, employees, agents, representatives, successors and assigns
harmless from and against any and all loss, liability, expense or damages, including (without limitation)
attorney’s fees, which any of them may incur as a result of personal injury, death or property damage
sustained by any child accompanying
me on volunteer activities.
While BOLM endeavors to keep out anyone who is a threat, I understand that program members,
guests and/or visitors may have been involved in criminal activity and/or been convicted of crimes,
including sexual offenses.
If my volunteer service includes driving an automobile, I acknowledge that I have both a valid driver’s
license and automobile liability insurance policy as required by state law. I agree to maintain my license and
insurance in good standing for my entire tenure as a volunteer for the organization. I am knowledgeable of
and agree to abide by local and state traffic laws.
I grant permission for Bread of Life Mission to use my image/likeness in their public
communications without payment or compensation.
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of
liability and I sign it of my own free will.
Volunteer Signature: Date: