Stream Cleanup with Mitsubishi!

I, the below named volunteer, regard this waiver as consideration to act as a volunteer for the Cumberland River Compact on the following terms:

ASSUMPTION OF RISKS

I understand that I am going to engage in a volunteer activity that has certain known and unknown risks that could result in physical or mental injury, death, illness, disease, or property damage to me or to other third parties.

I understand these risks, inherent in this outdoor activity, and voluntarily assume to participate in this event. I agree to adhere to all safety instructions from the event staff and to remove myself from any situation I may find hazardous to myself or beyond my physical capabilities.

RELEASE

I hereby release the Cumberland River Compact, it’s directors, officers, employees, agents, independent contractors, volunteers and sponsors (all of whom are referred to as the Releasees in this form) and any sponsors of the event from any and all liability for any loss, damage, injury or expense that I may suffer as a result of my participation in this event, including if caused by the negligence or gross negligence of any of the Releasees.

I hereby hold harmless and indemnify the Releasees from any and all liability, claims, actions or damages without any limitation whatsoever (including attorneys’ fees), whether consisting of loss, property damage, death or personal injury to me, my next of kin or any third party, resulting from my participation in this event.

I and my next of kin are duly aware of the risks and hazards inherent in this outdoor activity. I hereby voluntarily assume all risks of loss, illness, disease, damage, or injury that may be sustained by me or to any property while in or upon said premises or engaged in said event.

I recognize and agree that I am not allowed to participate in any of the above listed activities unless I sign this Waiver, and therefore I am receiving a benefit in exchange for signing this Waiver and it is binding on me. I agree that this Waiver is also binding on my heirs, executors, administrators and legal representatives.

PHOTO RELEASE

I consent to the use of, publication, distribution and display of pictures photographed on or about the date of the event in which I may appear, without restriction of any kind or nature whatsoever. I understand that I will not receive compensation, whatever the nature, now or in the future for the consent given herein.

MEDICAL RELEASE

I hereby give my consent to for Releasees to obtain and/or provide medical treatment for me, if necessary. I accept financial responsibility for the costs related to this medical treatment. I also hereby release and forever discharge any Releasees from any claim whatsoever that arises or may arise on account of any first aid, treatment, or other medical services rendered to me in connection with an emergency during this activity.

INVALID PROVISION

If any provision or any part of any provision of this document shall for any reason be held to be invalid, unenforceable, or contrary to public policy or any law, the remainder of the document shall not be affected thereby.

I have read and understand this waiver and hereby agree to participate in this event.

ELECTRONIC SIGNATURE CONSENT

By checking below, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

METROPOLITAN GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY

FREDDIE O’CONNELL
MAYOR

NASHVILLE DEPARTMENT OF TRANSPORTATION
AND MULTIMODAL INFRASTRUCTURE

VOLUNTEER WAIVER

I, (the undersigned), individually and/or as parent or legal guardian of the child, agree to indemnify and
hold harmless the Metropolitan Government of Nashville and Davidson county, its officers, agents and
employees from any claims, damages, costs and attorney fees for injuries, illness or damages arising out of
or suffered by me and/or my child as a result of my and/or my child’s participation in, or traveling to and
from, the Metro Beautification & Environment Commission’s Community Beautification and Clean-up
program.

I know this activity is potentially hazardous. My participation and/or my child’s participation in this
activity is purely voluntary. I assume all risks, both known and unknown, associated with this event,
including but not limited to: falls, contact with other participants and/or wildlife, the effect of the weather,
and physical conditions of this activity; all such risk being accepted by me.

I realize this event may involve strenuous activities that require good physical condition and hereby
certify that my child and I are in proper physical condition and in good health sufficient for the activities of
this event that my child and I voluntarily choose to participate in. In the event that I at any time feel that my child or I are not capable of continuing with any activity during the event, I will immediately notify a NDOT or Metro Beautification employee.

I acknowledge by signing below that I give my permission for Metro Beautification & Environment
Commission to use photographs/videos that include the participant listed below in promoting Metro
Beautification programs including posting images/videos on Metro’s website, newsletters, social media,
program promotional material, etc.

I acknowledge by signing below that I am at least 18 years old or am the legal guardian of the child
under 18 listed below and have read the volunteer liability release form and I agree to the terms and
conditions which are outlined within.