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2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Fax Number

14. WAIVER AND RELEASE FROM LIABILITY/ASSUMPTION OF RISK

    I, the undersigned, wish to serve as a volunteer to the City of Concord, participating in the following general activities:

16. To perform physical laboring tasks to assist with basic grounds keeping in the maintenance or alteration of landscaped or other areas, or with public works maintenance and construction activities: performs related and other work as required.

18. I agree to defend, indemnify, and hold harmless the City of Concord for any loss, claim, injury, or damage suffered by the City as a result of negligence or misconduct on my part, whether willful, knowing, or otherwise.
20. I am aware that serious accidents and injuries occasionally occur during activities such as those identified above. In consideration of my participation in said activity/those activities, I knowingly and voluntarily assume all risks arising therefrom, and release the City of Concord, and its officers, representatives, agents, employees and volunteers, from any and all claims, liens, damages, lawsuits, or liability for property damage, injury or death, resulting from, arising out of, or in any way connected with my participation in said activity/activities, and/or from my service as a volunteer.
22. I agree and acknowledge that this Waiver and Release From Liability/Assumption of Risk Agreement shall apply even in the event that negligent acts or omissions (other than sole, active negligence) on the part of the City of Concord, its officers, agents, employees, or volunteers may have caused or contributed to the death, injury or property damage.
24. I agree that this Waiver and Release from Liability/Assumption of Risk Agreement shall be and is binding upon my heirs, successors and assigns.
26. I HAVE READ THIS WAIVER AND RELEASE FROM LIABILITY/ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND IT, AND RECOGNIZE THAT IT IS A LEGALLY BINDING DOCUMENT. I SIGN THIS AGREEMENT FREELY, VOLUNTARILY, AND WITHOUT INDUCEMENT.*

    1. I agree
28. First Name*
29. Last Name*

31. AUTHORIZATION AND CONSENT FOR USE OF PHOTOGRAPH, VIDEO OR LIKENESS

    I understand that the City of Concord produces or creates various photographs, videos, promotional materials, brochures and media in other formats in order to promote the City. As such, I understand that my name, photograph(s), video image(s), voice or likeness may be depicted, used or appear in any of these photographic or video productions, promotional materials, brochures or other forms of media.

    I acknowledge and understand that I will not receive any compensation now or in the future for the use of my image and likeness as described above in the City's productions (including but not limited to video programs, brochures or other media).

    I further acknowledge and consent in accordance with California Civil Code Sections 3344 and 3344.1 to the use of my name, photographic or video image, voice or likeness in City's productions, promotional materials or media, and waive any right for future compensation or claim of damages or liability arising out of the use of said image or likeness.

    I also agree that all rights, title and interest in the City's productions shall vest and remain with the City of Concord.

33. I HAVE READ THIS AUTHORIZATION AND CONSENT FOR USE OF PHOTOGRAPH, VIDEO OR LIKENESS, FULLY UNDERSTAND IT, AND RECOGNIZE THAT IT IS A LEGALLY BINDING DOCUMENT. I SIGN THIS AGREEMENT FREELY, VOLUNTARILY, AND WITHOUT INDUCEMENT.*

    1. I agree
35. First Name*
36. Last Name*
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