Scroll to see more shifts & complete your submission at the bottom of the page.Click here to scroll down.
Waiver
Bayview Senior Services Volunteer Release and Waiver of Liability Form
This Release and Waiver of Liability (the “release”) executed on ________________ (date) by
______________________________________ (“Volunteer”) releases Bayview Hunters Point
Multipurpose Senior Services (also doing business under District 10 Community Market), a
nonprofit corporation organized and existing under the laws of the State of California and each
of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer
services for Bayview Hunters Point Multipurpose Senior Services (herein BHPMSS) and engage
in activities related to serving as a volunteer for BHPMSS.
Volunteer understands that the scope of Volunteer’s relationship with BHPMSS is limited to a
volunteer position and that no compensation is expected in return for services provided by
Volunteer; the BHPMSS will not provide any benefits traditionally associated with employment
to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event
of personal injury or illness as a result of Volunteer’s services to BHPMSS.
1. Waiver and Release: I, release and forever discharge and hold harmless BHPMSS and its
successors and assigns from any and all liability, claims, and demands of whatever kind of
nature, either in law or in equity, which arise or may hereafter arise from the services I provide to
BHPMSS. I understand and acknowledge that this Release discharges BHPMSS from any
liability or claim that I may have against BHPMSS with respect to bodily injury, personal injury,
illness including COVID-19 and any other unknown infectious diseases, death, or property
damage that may result from the services I provide to BHPMSS or occurring while I am
providing volunteer services.
2. Insurance: Further I understand that BHPMSS does not assume any responsibility for or
obligation to provide me with financial or other assistance, including but not limited to medical,
health, or disability benefits or insurance. I expressly waive any such claim for compensation or
liability on the part of BHPMSS.
3. Medical Treatment: I hereby Release and forever discharge BHPMSS from any claim
whatsoever which arises or may hereafter arise on account of any first-aid treatment or other
medical services rendered in connection with an emergency during my tenure as a volunteer with
BHPMSS.
1753 Carroll Avenue, San Francisco, CA 94124
(415) 822-1444 www.bhpmss.org
Dignity, Honor and Respect for Our Elders”
2
4. Assumption of Risk: I understand that the services I provide to BHPMSS may include
activities that may be hazardous to me including, but not limited to driving, lifting, pushing,
pulling, use of cleaning chemicals, etc. involving inherently dangerous activities. As a volunteer,
I hereby expressly assume risk of injury or harm from these activities and Release BHPMSS
from all liability.
5. Photographic Release: I grant and convey to BHPMSS all right, title, and interests in any and
all photographs, images, video, or audio recordings of me or my likeness or voice made by
BHPMSS in connection with my providing volunteer services to BHPMSS.
6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and
inclusive as permitted by the laws of the State of California and that this Release shall be
governed by and interpreted in accordance with the laws of the State of California. I agree that in
the event that any clause or provision of this Release is deemed invalid, the enforceability of the
remaining provisions of this Release shall not be affected.
By signing below, I express my understanding and intent to enter into this Release and Waiver
of Liability willingly and voluntarily.
_______________________________________________ ____________________
Signature (Or parent/guardian if under 18) Date
VOLUNTEER INFORMATION:
Name: ______________________________________________Birthdate ________________
Mailing Address
____________________________________________________________________________
City ___________________________________________State ________________________
ZIP _________________
Cell: __________________________________ Work: _______________________________
E-mail :______________________________________________________________________
1753 Carroll Avenue, San Francisco, CA 94124
(415) 822-1444 www.bhpmss.org
Dignity, Honor and Respect for Our Elders”
3
Are you part of a group? Yes or No
Company/group Name:
______________________________________________
Emergency Contact:
______________________________________________________________
Contact Relationship: ____________________ Emergency Phone Number: ______________
Would you like to receive BHPMSS/ District 10 Community Market emails and newsletters?
Yes or No
Volunteer Expectations Agreement
1. Volunteers working in any capacity within BHPMSS must be at least 15 years of age or older.
2. If any task causes you discomfort, or if you feel it is unsafe or unhealthy to perform a specific
task, report the condition to a BHPMSS staff member immediately.
3. Wear sensible, appropriate clothing and footwear for the task(s) at hand.
*** Closed toed shoes, short to long sleeves tops the reach or pass the waist, and pants are
required for all District 10 Community Market activities. ***
4. Wash hands before beginning your shift, after eating, and after using the restroom.
5. Alcohol and other drugs are STRICTLY PROHIBITED in the workplace.
6. No Smoking” policy – Smoking in designated area only.
7. Only authorized personnel may operate machines or equipment.
8. Report any injury immediately to BHPMSS staff on site.
9. No food, drink (exception to closed bottles of water), and ABSOLUTELY NO cell phone
usage in the District 10 Community Market while volunteering.
(if you must use your cell phone please relocate to an office or the volunteer area)
10. Please avoid conversations, comments and language that are inappropriate in a professional
workplace.
11. Do not take any food from the BHPMSS without proper authorization from BHPMSS staff..
I have read the Volunteer Expectations Agreement and agree
Signature ______________________________________ Date_________________________
Bayview Senior Services Volunteer Release and Waiver of Liability Form
This Release and Waiver of Liability (the “release”) executed on ________________ (date) by
______________________________________ (“Volunteer”) releases Bayview Hunters Point
Multipurpose Senior Services (also doing business under District 10 Community Market), a
nonprofit corporation organized and existing under the laws of the State of California and each
of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer
services for Bayview Hunters Point Multipurpose Senior Services (herein BHPMSS) and engage
in activities related to serving as a volunteer for BHPMSS.
Volunteer understands that the scope of Volunteer’s relationship with BHPMSS is limited to a
volunteer position and that no compensation is expected in return for services provided by
Volunteer; the BHPMSS will not provide any benefits traditionally associated with employment
to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event
of personal injury or illness as a result of Volunteer’s services to BHPMSS.
1. Waiver and Release: I, release and forever discharge and hold harmless BHPMSS and its
successors and assigns from any and all liability, claims, and demands of whatever kind of
nature, either in law or in equity, which arise or may hereafter arise from the services I provide to
BHPMSS. I understand and acknowledge that this Release discharges BHPMSS from any
liability or claim that I may have against BHPMSS with respect to bodily injury, personal injury,
illness including COVID-19 and any other unknown infectious diseases, death, or property
damage that may result from the services I provide to BHPMSS or occurring while I am
providing volunteer services.
2. Insurance: Further I understand that BHPMSS does not assume any responsibility for or
obligation to provide me with financial or other assistance, including but not limited to medical,
health, or disability benefits or insurance. I expressly waive any such claim for compensation or
liability on the part of BHPMSS.
3. Medical Treatment: I hereby Release and forever discharge BHPMSS from any claim
whatsoever which arises or may hereafter arise on account of any first-aid treatment or other
medical services rendered in connection with an emergency during my tenure as a volunteer with
BHPMSS.
1753 Carroll Avenue, San Francisco, CA 94124
(415) 822-1444 www.bhpmss.org
Dignity, Honor and Respect for Our Elders”
2
4. Assumption of Risk: I understand that the services I provide to BHPMSS may include
activities that may be hazardous to me including, but not limited to driving, lifting, pushing,
pulling, use of cleaning chemicals, etc. involving inherently dangerous activities. As a volunteer,
I hereby expressly assume risk of injury or harm from these activities and Release BHPMSS
from all liability.
5. Photographic Release: I grant and convey to BHPMSS all right, title, and interests in any and
all photographs, images, video, or audio recordings of me or my likeness or voice made by
BHPMSS in connection with my providing volunteer services to BHPMSS.
6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and
inclusive as permitted by the laws of the State of California and that this Release shall be
governed by and interpreted in accordance with the laws of the State of California. I agree that in
the event that any clause or provision of this Release is deemed invalid, the enforceability of the
remaining provisions of this Release shall not be affected.
By signing below, I express my understanding and intent to enter into this Release and Waiver
of Liability willingly and voluntarily.
_______________________________________________ ____________________
Signature (Or parent/guardian if under 18) Date
VOLUNTEER INFORMATION:
Name: ______________________________________________Birthdate ________________
Mailing Address
____________________________________________________________________________
City ___________________________________________State ________________________
ZIP _________________
Cell: __________________________________ Work: _______________________________
E-mail :______________________________________________________________________
1753 Carroll Avenue, San Francisco, CA 94124
(415) 822-1444 www.bhpmss.org
Dignity, Honor and Respect for Our Elders”
3
Are you part of a group? Yes or No
Company/group Name:
______________________________________________
Emergency Contact:
______________________________________________________________
Contact Relationship: ____________________ Emergency Phone Number: ______________
Would you like to receive BHPMSS/ District 10 Community Market emails and newsletters?
Yes or No
Volunteer Expectations Agreement
1. Volunteers working in any capacity within BHPMSS must be at least 15 years of age or older.
2. If any task causes you discomfort, or if you feel it is unsafe or unhealthy to perform a specific
task, report the condition to a BHPMSS staff member immediately.
3. Wear sensible, appropriate clothing and footwear for the task(s) at hand.
*** Closed toed shoes, short to long sleeves tops the reach or pass the waist, and pants are
required for all District 10 Community Market activities. ***
4. Wash hands before beginning your shift, after eating, and after using the restroom.
5. Alcohol and other drugs are STRICTLY PROHIBITED in the workplace.
6. No Smoking” policy – Smoking in designated area only.
7. Only authorized personnel may operate machines or equipment.
8. Report any injury immediately to BHPMSS staff on site.
9. No food, drink (exception to closed bottles of water), and ABSOLUTELY NO cell phone
usage in the District 10 Community Market while volunteering.
(if you must use your cell phone please relocate to an office or the volunteer area)
10. Please avoid conversations, comments and language that are inappropriate in a professional
workplace.
11. Do not take any food from the BHPMSS without proper authorization from BHPMSS staff..
I have read the Volunteer Expectations Agreement and agree
Signature ______________________________________ Date_________________________
Check here to show you accept the terms stated above for yourself or for a minor volunteer for which you are a parental guardian.
