Mobile Loaves & Fishes
Visitor Agreement and Waiver Release Form
This agreement is between the person signed up to visit Community First! Village (“Visitor”) and Mobile Loaves & Fishes (“MLF”). Visitor will be observing MLF’s Community First! Village and related outreach to homeless and poor people, which includes delivery of food (which may or may not use MLF vehicles), providing housing, as well as witnessing any other MLF program or project it offers from time to time.
As a condition of my being accepted as a MLF visitor, I hereby agree to the following: I acknowledge and agree that the nature of visit to Community First! Village may include (a) contact with unidentified, unfamiliar, and unpredictable persons (b) travel to and from various unspecified locations, (c) potential exposure to persons with infectious diseases, and (d) other potential risk of injury. I willingly and freely agree to the visit and hereby assume any and all hazards or risk associated with the visit to Community First! Village, including without limitation risk of accident, personal injury, or death to my person or property which I may sustain in connection with my participation as a MLF visitor in any MLF related project or activity. I am aware that I must follow any safety and hygiene protocols that have been implemented by MLF. I attest that I am not experiencing any symptoms of illness such as fever, cough, or shortness of breath.
Visitor hereby releases and covenants not to sue MLF and its directors, officers, partners, agents, employees, successors, assigns, licensees, sponsors, donors, representatives, volunteers, guests and affiliates from all liability, claims, suits, damages or cause(s) of action, whether known or unknown, arising out of or based upon or relating to my visit to Community First! Village or any other MLF related activity or project for any and all property damage, personal injury or death sustained by me or my minor child. I will indemnify and hold harmless MLF from any loss, liability, damage, cost or expense that they may incur as the result of any property damage or injury or death that I or my child may sustain while visiting Community First! Village. I hereby acknowledge that MLF is an organization involved in serving the chronically homeless. I hereby confirm, represent and warrant that I have never been convicted of a violent crime.
I request and authorize MLF to provide, in their judgment, any immediate medical or emergency care my child may need due to injury or sickness. MLF can share information concerning the medical condition/treatment of my child to medical personnel or others MLF in its discretions determines is necessary to treat my child.
Media Release
I hereby consent to being the subject of photographs taken by Mobile Loaves & Fishes, Inc. during my or my child’s visit to Community First! Village, and authorize Mobile Loaves & Fishes, Inc. to cause the photographs to be exhibited with or without advertising sponsorships as still photographs, transparencies, motion pictures, television, social media or video. By this document I release Mobile Loaves & Fishes, Inc., their agents, employees or assigns, from any and all claims for damages, libel, slander, invasion of privacy or any other claim based upon the use of my likeness.
Having read this Waiver/Release Form, I agree to the terms and conditions expressed herein.
