Youth Volunteer Authorization and Liability Release

As the parent, legal guardian, or custodian of

who is

years old, I authorize him/her to serve as a volunteer at Phoenix Rescue Mission (PRM). I understand that PRM’s Christian ministry serves all kinds of people in need. I also understand that PRM does not admit clients or work with volunteers that have any prior or pending charges that involve violence, arson, sex, children or the elderly. However, I understand there may be persons in PRM shelters or on-site with unknown backgrounds when the above named minor serves as a volunteer.

In exchange for PRM’s agreement to allow the above named minor to serve as a volunteer:

I agree that he/she will be accompanied and supervised at all times by me or another responsible adult from (name of sponsoring organization)

I, hereby, release PRM, including its officers, agents and employees from any and all claims of liability of any kind whatsoever, including claims of negligence and/or personal injury to above-named minor in connection with his/her volunteer service. I understand that by signing below I am waiving any and all such claims of liability.

I acknowledge that photographs and/or video may be taken of so-said youth volunteer and used by PRM, media outlets, and third party vendors commissioned by PRM for fundraising and other publicity. If I am uncomfortable with releasing this minor's photographic rights, I know that in order to opt out I must contact PRM's Volunteer Services at (602)346-3363 or volunteer@phoenixrescuemission.org with my opt out request. I have full authority to authorize this release.

Signature of Parent, Legal Guardian, or Chaperone (Typing my name in the space below serves as my digital signature.)

Today's Date

All information disclosed above will remain confidential to the Phoenix Rescue Mission.