In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, release and discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter occur to me including my traveling to and from this event, the following entities or persons: Arizona Dental Foundation and Arizona Dental Association their directors, officers, employees, volunteers, representatives, and agents, the even holders, event sponsors, event volunteers; (B) Indemnify and hold harmless, and agree not to sue the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of releases or otherwise. I hereby consent to receive medical treatment that may be deemed advisable in the event of injury, accident and/or illness during this event. By registering for this event, I grant the Arizona Dental Foundation and its agents the right to use my picture, voice, and other reproductions in connection with advertising or publicizing ADF/AzDA and its activities in all forms of media related to this event.
All volunteers must read and sign our NEW COVID-19 VOLUNTEER PARTICIPATION AGREEMENT and review our new Safety Guidelines for Volunteering in Person prior to signing up and attending this event.
Safety Guidelines for Volunteering in Person
The safety of our partners, volunteers, and everyone involved in our events is our first priority. If any of the below applies to you, please DO NOT SIGN UP to volunteer with us.
- You are sick or display symptoms of COVID-19 within one week of the event.
- You have traveled within the past 14 days or come in to contact with someone who has tested positive within one week of the event.
- You have pre-existing conditions such as chronic lung disease, heart disease, diabetes, cancer, or a weekend immune system.
While volunteering in-person, all volunteers must adhere to the below requirements. Our Volunteer Leaders will provide a safety orientation at the beginning of each event. Please review our NEW, REQUIRED Volunteer Participation Agreement before signing up for in-person opportunities.
- Wear a face covering. People who do not show symptoms may still be able to spread COVID-19. Face coverings include anything that covers your nose and mouth, including dust masks, scarves, and bandanas. Please provide your own face covering. Check out the CDC Guidelines for mask making that include sewing and no-sew options, a Video or Instructions for mask making.
- Wash your hands often, including at the start and end of your volunteer opportunity. Use soap and water, scrub for at least 20 seconds. Gloves are recommended if holding children’s hands.
- Cover your mouth and nose with a tissue or your sleeve when sneezing or coughing.
- Don't touch your eyes, nose or mouth with unwashed hands. Do not shake hands.
- Don't gather in large groups; and when possible, maintain at least a six-foot distance between you and others.
- Bring a signed Volunteer Participation Agreement to each in-person opportunity you attend.
Duty to Self-Monitor:
Participants and volunteers agree to self-monitor for signs and Symptoms of COVID-19 (symptoms typically include fever, cough, and shortness of breath) and contact ADF penny @azda.org or 480-344-5777x325 if he/she experiences symptoms of COVID 19 within 14 days after the event.
Arizona Dental Foundation Volunteer COVID-19 Agreement, Assumption of Risk & Waiver of Liability
- I attest that I am not experiencing any symptoms of illness such as a fever, cough, or shortness of breath. If I develop these symptoms, I agree that I will cancel my shift before arriving at the volunteer event site, as far in advance as possible.
- I am aware that I must follow the safety and hygiene protocols that have been implemented by the Center for Disease Control (CDC) and event site where I am volunteering.
- I attest that:
- I have not traveled internationally in the past 14 days;
- I have not traveled to a highly Impacted area within the United States in the past 14 days;
- I do not believe that I have been exposed to a person with a confirmed or suspected case of COVID-19;
- I have not been diagnosed with COVID-19 and not yest cleared as non-contagious by state or local public health authorities;
- I am following recommended guidelines as much as possible – practicing social distancing by participating in group activities of fewer than 10, trying to maintain separation of six feet from others, and otherwise limiting my exposure to the coronavirus.
I acknowledge that I have voluntarily applied to the Arizona Dental Foundation (ADF) programs. I understand that the scope of my volunteer relationship with the Arizona Dental Foundation and Arizona Dental Association (AZDA) is limited to an event site; that ADF /AZDA will not provide any benefits traditionally associated with employment; and that I am responsible for my own insurance coverage in the event of illness or personal injury as a result of my services to the Arizona Dental Foundation.
I understand that my volunteer activities with ADF/AZDA my include activities that could be hazardous to me, including but not limited to packing, loading, unloading, and carrying heavy items, use of dental tools, supplies, and equipment, transportation to and from work sites, exposure to children and adults with infectious diseases. I fully understand and appreciate the risks that are inherent to my volunteer activities and understand that I may decline to participate in any activity or task for which I do not wish to assume the risk. However, ADF/AZDA cannot guarantee that its participants, volunteers, partners, or others in attendance will not become infected with COVID-19. I hereby assume the risk of bodily injury, illness, death, medical treatment, economic loss, out of pocket expenses, and property damage resulting from my volunteer activities, even if resulting from the negligence of ADF/AZDA or its officers, directors, employees, or agents. I hereby release, discharge and agree in indemnify and hold ADF/AZDA harmless from, and waive on behalf of myself and my heirs and personal representatives and any minors I am responsible for who volunteer with me, any and all causes of action, claims, demands, damages, costs, expenses, and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of ADF/AZDA, or that may otherwise arise in any way in connection with any voluntary activities with, or for ADF.
I understand that this release discharges ADF/AZDA from any liability or claim that I or my heirs, person representatives or minors I am responsible for may have against ADF/AZDA with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from in in connection with my volunteer activities. This liability waiver and release extends to ADF/AZDA together with all of its officers, directors, affiliates, employees, and agents. I grant full permission for organizers to use photos of me and quotations from me in legitimate accounts and promotions of the event. By registering for this event, I grant ADF/AZDA and its agents the right to use my picture, voice, and other reproductions in connection with advertising or publicizing Arizona Dental Foundation, Arizona Dental Association, and American Dental Association and its activities in all forms of media related to this event. BY ATTENDING AND/OR PARTICIPATING IN THE EVENT, YOU ARE DEEMED TO HAVE GIVEN A FULL RELEASE OF LIABILITY TO THE RELEASED PARTIES TO THE FULLEST EXTENT PERMITTED BY LAW.