Mentor Acknowledgement

Mentors Release and Waiver of Liability

Mentors Release and Waiver of Liability

This Release and Waiver of Liability (the "release") executed on the above date by the name above ("Volunteer") releases Los Angeles Team Mentoring ("Nonprofit"), a nonprofit corporation organized and existing under the laws of the State of California and each of its directors, officers, employees, and agents. I, the Volunteer, desires to provide volunteer services for Los Angeles Team Mentoring and engage in activities related to serving as a volunteer.

Volunteer understands that the scope of Volunteer's relationship with Los Angeles Team Mentoring  is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Los Angeles Team Mentoring 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 Los Angeles Team Mentoring.

1. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Los Angeles Team Mentoring 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 Los Angeles Team Mentoring. I understand and acknowledge that this Release discharges Los Angeles Team Mentoring from any liability or claim that I may have against Los Angeles Team Mentoring with respect to bodily injury, personal injury, illness, death, or property loss or damage that may result from the services I provide to Los Angeles Team Mentoring or occurring while I am providing volunteer services.

2. Insurance: Further I understand that Los Angeles Team Mentoring 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 Los Angeles Team Mentoring in the event of injury or medical expenses incurred by me.

3. Medical Treatment: I hereby Release and forever discharge Los Angeles Team Mentoring 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 Los Angeles Team Mentoring.

4. Assumption of Risk: I understand that the services I provide to Los Angeles Team Mentoring may include activities that may be hazardous to me including, but not limited to, serious injury and death, and involving inherently dangerous activities. As a volunteer, I hereby expressly assume risk of injury, death or harm from these activities and Release Los Angeles Team Mentoring from all liability.

5. Photographic Release: I grant and convey to Los Angeles Team Mentoring all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Los Angeles Team Mentoring in connection with my providing volunteer services to Los Angeles Team Mentoring.

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.

7. I certify that the information included my mentor application is valid and accurate to the best of my knowledge. I authorize Los Angeles Team Mentoring (LATM) to conduct a criminal, child abuse and driving record check by the Los Angeles Police Department, California Department of Justice and Federal Bureau of Investigation; and I further authorize anyone listed as a reference on this form to give LATM any information regarding my character and suitability for working with children.

I also release all references from liability for any damages that may result from furnishing such information. Furthermore, I understand that LATM is not obligated to provide a reason for their decision in accepting or rejecting me as a mentor with their agency. By signing above, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.