VOLUNTEER RELEASE AND WAIVER OF LIABILITY FORM

This Release and Waiver of Liability (the “Release”) releases Home Sweet Home, (“Nonprofit”), a nonprofit corporation organized and existing under the laws of the State of Missouri and each of its directors, officers, employees, other volunteers, affiliates and agents. The Volunteer desires to provide volunteer services for Nonprofit and engage in activities related to serving as a volunteer.

Volunteer understands that the scope of Volunteer’s relationship with Nonprofit is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; the Nonprofit 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 Nonprofit.

1. Acknowledgement of Risk or Possibility of Injury:   As a Volunteer with Nonprofit, I recognize the risk and acknowledge that there are certain risks of physical injury – including death, damages, property damage or loss – which I may sustain as a result of participating in any and all activities connected with Nonprofit, or the use of Nonprofit’s facilities or equipment.

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

3. Medical Treatment:    I hereby Release and forever discharge Nonprofit 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 Nonprofit.

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

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

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 Missouri and that this Release shall be governed by and interpreted in accordance with the laws of the State of Missouri. 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.

I acknowledge (a) that I have read (or have had read to me) provisions in this waiver and release of liability agreement, (b) that I understand each of the provisions in this agreement, (c) that I agree to abide by them and (d) and voluntarily sign my name evidencing my acceptance of the above provisions.