top of page

Individual Disclaimer Form

Boys & Girls Clubs of Kootenai County's Disclaimer, Assumption of Risk, and Waiver Form

Please complete and submit this form after you have completed and submitted your Individual Volunteer Application.

Please read this document carefully, as your electronic signature indicates that you have agreed to sign away rights. In consideration of being permitted to enter the Boys and Girls Club of Kootenai County (the "Club") facilities for any purpose and to participate in any program, event, or activity affiliated with the Club, whether or not located on Club premises, I agree to the following:

1)  Not Childcare - I acknowledge that the Club provides recreational services ONLY, it does not provide child care services, and its programs and activities should not be used for such purposes.

2)  Release - For myself and anyone who claims by and through my stead, I forever release and promise not to sue the Club, its Board of Governors, officials, agents, volunteers, exhibitors, and/or any other person or company in any way associated with the Club, to the maximum extent allowed by law, from any and all liability, claims, demands, damages, or any other legal responsibilities in any way related to the use of the Club or its facilities or participation in any Club programs, events, or activities. This release includes without limitation any and all claims, foreseeable and unforeseeable, relating to physical or other injury, death, or damage to property and any and all claims relating to negligence or negligent instruction, hiring, supervision, inspection, or maintenance.

3)  Indemnification - / forever agree to indemnify and reimburse the Club for any damages or liabilities it may incur due to my presence or actions, or the presence or actions of members of my family or my household, or individuals I invite or for whom I am responsible upon or about the Club's premises or in any way observing or using any facilities or equipment of the Club or participating in any program affiliated with the Club, whether on the Club's premises or elsewhere, including but not limited to damages or liability resulting from the negligence of the Club to the maximum extent allowed by law.

4)  Assumption of Responsibility/Risk - I forever assume full responsibility for any and all risk, known and unknown, of bodily injury, death, or property and other damage to me due to the negligence of the Club or any other cause (foreseeable or unforeseeable) to the maximum extent allowed by law, while in, about or upon the premises of the Club, while using the premises or any Club facilities or Club equipment, or while participating in any program affiliated with the Club, whether or not the injury occurs on the Club's premises. I understand the risks inherent in the activities that the Club sponsors and assume all such risks, as well as all non-inherent risks.

5)  Inspection - I agree that participation in any program affiliated with the Club is an acknowledgement that I have inspected the premises, facilities, equipment, and programs and that I find them to be safe for my observation, use, and participation. I make this acknowledgement for myself, my personal representatives, heirs, assigns, and next of kin.

6)  Regardless of Location - I understand that the Club often takes participants off-site and that this Waiver applies to all field trips, excursions, and any and all other off-site activities, regardless of where the Club's programs or activities take place.

7)  Medical Consent - If I should suffer injury or illness, I grant permission for the Club to use its discretion to have me transported to a medical facility for medical care and treatment, and I take full responsibility for this action. Further, I agree to be fully responsible for the cost of any such medical treatment.​

8)  Photos, Videos/Recordings - I acknowledge that from time to time photos, recordings, or videos may be taken of Club members and volunteers engaged in Club-related activities and used in Club promotional materials (such as Club newsletters and Club web pages) and educational materials or submitted to local newspapers, publications, and TV stations to promote the Club, recognize member and/or volunteer achievement, and raise money. By signing below, I consent to the use of images or recordings of myself to be used for public relations, news articles, telecasts, education, marketing, research, inclusion on the Club's website, fund raising, or any other purpose by the Club. I release the Club, their officers, directors, and employees, and each and all persons involved, from any liability in connection with the taking, recording, or publication of photographs, slides, computer images, videotapes, or sound recordings of myself. Further, I waive all rights to any claims for payment or royalties in connection with any exhibition, televising, or other publication of these materials. I also waive any right to inspect or approve any photo, video, or film taken by the Club, or the person or entity designated by it. Note: If you wish to rescind or amend this consent at any time, please contact the Club.

I intend that this Waiver be as broad and inclusive as permitted by law and that, if any portion of this Waiver should be deemed invalid, the remainder will continue in full legal force and effect. I also intend that this Waiver will remain in full legal force and effect forever, regardless of whether or not my volunteer status has expired.

I have read, understand, and voluntarily sign the Boys and Girls Club of Kootenai County's Disclaimer, Assumption of Risk, and Waiver form. I further agree that no oral representations, statements, or inducements apart from the foregoing Waiver have been made. By electronically signing this Waiver, I have agreed to all of the Waiver's terms, and I give the Boys & Girls Club of Kootenai County permission to background check me before I come into the Club.

Thanks for signing and submitting this Waiver. We'll get back to you soon.

bottom of page