Volunteer Release and Waiver of Liability

Volunteer Release and Waiver of Liability

  • This Volunteer and Waiver of Liability is in favor of Heartland Regional Medical Center dba Mosaic Life Care, a nonprofit corporation organization and existing under the laws of the State of Missouri, and each of its affiliated businesses and subsidiaries, and their directors, officers, employees, agents, and insurers ("Mosaic Life Care.")

    I, the Volunteer, desire to provide volunteer services to Mosaic Life Care and engage in activities related to serving as a volunteer (the "activities.") I understand that the scope of this type of relationship with Mosaic Life Care is limited to volunteer position and that, as such, no compensation or other benefits traditionally associated with employment are expected in return for the activities performed.

    To my knowledge, I am in good health and suffer no mental or physical impairment that would or should prevent my participation in the activities, and in consideration for being allowed to participate in volunteer services to Mosaic Life Care, execute this release under the following terms:
  • 1. Release and Waiver

    I do hereby release and forever discharge and hold harmless Mosaic Life Care and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my activities with Mosaic Life Care. I UNDERSTAND THAT THIS RELEASE DISCHARGES MOSAIC LIFE CARE FROM ANY LIABILITY OR CLAIM THAT I MAY HAVE AGAINST MOSAIC LIFE CARE WITH RESPECT TO BODILY INJURY, PERSONAL INJURY, ILLNESS, DEATH, OR PROPERTY DAMAGE THAT MAY RESULT FROM MY ACTIVITIES WITH MOSAIC LIFE CARE, WHETHER CAUSED BY THE NEGLIGENCE OF MOSAIC LIFE CARE OR OTHERWISE.
  • 2. Insurance

    I understand that Mosaic Life Care does not assume any responsibility for or obligation to provide financial assistance or other assistance, including, but not limited to, medical, health, or disability insurance in the event of my injury or illness. Each volunteer is expected and encouraged to obtain his or her own medical, health, and/or disability insurance coverage. I expressly waive any such claim for compensation or liability on the part of Mosaic Life Care beyond what may be offered freely by Mosaic Life Care in the event of such injury or medical expense.
  • 3. Medical Treatment

    I hereby release and forever discharge Mosaic Life Care 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 any activities with Mosaic Life Care.
  • 4. Assumption of Risk

    I understand that the activities I will perform may include tasks that may be hazardous to me, including, but not limited to, transporting patients, cleaning or wiping down equipment, passing meal trays, answering call lights, visiting with patients, driving the auxiliary van, typing/data entry, lifting merchandise equipment, assisting at entrances, and other duties as assigned. I am also aware of the highly contagious nature of the 2019 novel coronavirus disease (COVID-19) and the risk that I may be exposed to or contract COVID-19 by engaging in the activities, which may result in serious illness, prolonged hospitalization, injury, disability, or death, as well as the potential spread to other individuals. I acknowledge that these risks may result from or be compounded by the actions, omissions, or negligence of Mosaic Life Care or others. I understand that while Mosaic Life Care has implemented measures to reduce the risk of injury from the activities and the spread of COVID-19, Mosaic Life Care cannot guarantee that I will not be injured or become infected with COVID-19 due to my participation in the activities. I hereby expressly and specifically assume the risk of injury or harm for these activities and release Mosaic Life Care from all liability for injury, illness, death, or property damage resulting from the activities.
  • 5. Photographic Release

    I hereby grant and convey to Mosaic Life Care all right, title, and interests in any and all photographic images and video or audio recordings made by Mosaic Life Care, during my activities with Mosaic Life Care, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
  • 6. Other

    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 will be governed by and interpreted in accordance with the laws of the State of Missouri. I also agree that in the event that any clause or provision of this release is deemed invalid, the enforceability of the remaining provisions will not be affected.
  • I HAVE CAREFULLY READ THIS VOLUNTEER WAIVER AND RELEASE OF LIABILITY, AM RELYING SOLELY UPON MY OWN JUDGMENT WITHOUT INFLUENCE BY ANYONE, FULLY UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING, AND NOW FREELY AND VOLUNTARILY SIGN WITHOUT ANY INDUCEMENT.
  • Date Format: MM slash DD slash YYYY
  • If under the age of 18.
  • If under the age of 18.