Youth Volunteer Authorization and Liability Release

    As the parent, legal guardian, or custodian of

    who is

    years old (the “Volunteer”), 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 understand there may be persons in PRM shelters or on-site with unknown backgrounds when the above named minor serves as a volunteer.

    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. I certify that the Volunteer does not have, and never has had, any known warrants or have any prior or pending charges for crimes involving violence, arson, sex, children, or the elderly. I acknowledge that individuals with prior crimes involving violence or with an open Department of Child Safety case attached to a child abuse charge may be admitted at staff discretion depending on the nature, severity and recent history. 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 Volunteer 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

    I acknowledge that I am solely responsible for supervising and ensuring the Volunteer’s safety and PRM undertakes no responsibility for the safety or supervision of the Volunteer.

    I assume all responsibility and risk that may be involved in the Volunteer’s opportunity at PRM facilities. I do release and relinquish forever all claims, known or unknown, whatsoever against PRM and its members, principals, officers, directors, employees, agents, representatives, successors and assigns that may arise out of and/or in connection with the Volunteer’s opportunity to serve at PRM for the Volunteer and his/her heirs, executors, administrators, or any other personal representatives. I understand that by signing below I am waiving any and all such claims of liability.

    I agree to indemnify and hold harmless PRM and its members, principals, officers, directors, employees, agents, representatives, successors and assigns from and against any and all loss, liability, expense or damages, including (without limitation) attorneys' fees, which any of them may incur as a result of personal injury, death or property damage caused or alleged to be have been caused by Volunteer in connection with his/her volunteer service. I understand that by signing below I am agreeing to indemnify PRM.

    I acknowledge that photographs and/or video may be taken of the Volunteer and used by PRM, media outlets, and third party vendors commissioned by PRM for fundraising and other publicity and expressly consent to the taking and use of said photographs and/or video and waive any rights the Volunteer may have to those photographs and/or videos. If I am uncomfortable with releasing Volunteer’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 prior to any volunteer opportunity with PRM. I have full authority to authorize this release on behalf of the Volunteer.

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

    Email Address

    Today's Date

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