Community Service Release Form

Roanoke Public Library

 

Community Service Liability Release

 

It is understood that the community service volunteer will perform solely as an individual on a voluntary basis.  The community service volunteer is not an employee, contractor, or agent of the Roanoke Public Library, the Roanoke Public Library Board of Trustees, its employees or officials or persons or agencies for whom community service is provided.  It is also understood that the community service volunteer will not receive any benefits or compensation, except as specifically provided for in this agreement.

 

It is further understood the community service volunteer will be working under the supervision of the Roanoke Public Library staff.  The community service volunteer is responsible for seeing that the work sheet given to them by the Court or Youth Service Bureau is signed each day of work.  The community service volunteer is responsible for their work record.  The community service volunteer will perform whatever duties assigned by the Library staff.  Duties repeatedly not done correctly and/or in a timely manner may result in their service opportunity being terminated.  If the community service volunteer misses a scheduled date and time of service without prior notification, their service opportunity may be terminated.

 

It is further agreed that the undersigned does hereby compromise and forever release, acquit, discharge, indemnify, and covenant to hold harmless the Roanoke Public Library, the Roanoke Public Library Board of Trustees, its employees and officials and any agency or person for whom community service is performed.  Also from any and all actions, cause of action, claims, liability, demands, damages, costs, loss of service, medical expense and compensation, on account of, or in any way growing out of any and all known and unknown personal injuries, property damage, or other type of damage which the undersigned may herein after have, individually and/or as a parent or guardian of said community service volunteer, resulting from this Community Service Contract/Agreement and the participation of the community service volunteer in the volunteer service work at the Roanoke Public Library.

 

In making this agreement and signing this liability release, we do so freely and voluntarily and rely wholly upon our own judgment, belief, and knowledge and have not been influenced to any extent whatsoever by any representation or statements not contained in this agreement.

 

 

 

 Community Service Volunteer

 

 

 

Parent/Guardian if under 18 years of age

 

 

 

Roanoke Public Library Staff

 

 

 

Date

 

 

126 N. Main Street, PO Box 249, Roanoke, IN 46783    260-672-2989   www.roanoke.lib.in.us   director@roanoke.lib.in.us