Catholic Charities Waiver Release

RELEASE, HOLD HARMLESS AND INDEMNITY AGREEMENT

In consideration of my being allowed to participate in the repair and clean-up effort sponsored by Catholic Charities Archdiocese of New Orleans, in , Louisiana, I, __________________________________(hereinafter “Releasor”), a person of the full age of majority and a resident of the County/Parish of , State of _________, do hereby acknowledge that:

1) I voluntarily have chosen to travel to the foregoing area to perform cleanup and/or construction efforts in disaster relief at various types of houses and/or buildings (hereinafter “volunteer effort”;

2) I understand that this volunteer effort entails a risk of physical and/or mental and/or emotional injury and often involves hard physical labor, heavy lifting, and/or other strenuous activity, which activity may include climbing on ladders and building framing other than on ground level;

3) I understand that the volunteer effort may expose me to harmful and/or illness-causing substances, including but not limited to mold and/or mildew;

4) I am in good health and physically and emotionally able to perform the foregoing volunteer effort.

I further understand that I am engaging in this volunteer effort at my own risk and will be exposed to various injury-causing risks, including but not limited to contracting of illnesses and/or incurring physical injuries. I also understand that I am assuming any and all risk of any injury or damages of any type that I may sustain, including but not limited to physical, mental, or financial injuries (e.g., loss of wages). I also understand that I am solely responsible for any and all costs and/or expenses that I may incur arising out of my participation in the volunteer effort, including but not limited to any costs and/or expenses arising out of housing, meals, and/or losses from theft.

I also understand that in performing services for the volunteer effort that if I become injured, because of the conditions of the City of New Orleans and its environs I may not have available to me the same level of medical care that I may be accustomed to which may subject me to further, additional risks of physical and/or emotional injury or damage and/or may increase the severity of such injury or damage.

I further understand that in the event that I am offered any housing accommodations while participating in the volunteer effort, I will abide by whatever regulations may be in effect for the accommodations at the time.

In consideration of my being able to participate in the volunteer effort, which participation I acknowledge has intrinsic value and worth to me, I further agree to release, indemnify and hold harmless The Roman Catholic Church of the Archdiocese of New Orleans, Catholic Charities Archdiocese of New Orleans, any other related entity of the Archdiocese of New Orleans, whether separately incorporated or not, including but not limited to Parishes, and their members, officers, directors, executives, administrators, pastors, clergy, faculty, administrators, employees, representatives, insurers, reinsurers and/or self-insurance administrators, assigns and/or representatives (hereinafter collectively referred to as “the Releasees”) of and from any and all manner of actions, suits, liens, debts, damages, injuries (including but not limited to claims for bodily injury, mental anguish and/or death), economic damages (including but not limited to loss of wages and loss by theft), claims arising from travel or lodging and any and all other claims and demands whatsoever (hereinafter, collectively, “claims”), at law or in equity, and arising out of or under any law of the United States, or any of the several states, including but not limited to the laws of the State of Louisiana, including but not limited to the laws of obligations and/or laws of tort and/or delict, arising from my participation in volunteer effort, whether such claims or causes of action arise from my own negligence, strict liability or fault or from the negligence, strict liability or fault of Releasees or any third parties for whom the volunteer effort is performed. Releasor specifically acknowledges that this agreement includes a Release, Hold Harmless and Indemnity in favor of Releasees and third parties for their own negligence, strict liability or fault of any kind or nature whatsoever.

I further agree that this Agreement shall be construed in accord with the laws of the State of Louisiana, which shall be the forum for any dispute concerning my participation in the volunteer effort. I further acknowledge and agree that the terms and conditions of this Agreement shall be severable and that if any term or condition shall be held to be illegal, unenforceable or in conflict with the laws of the State of Louisiana, the validity of the remaining portions of the Agreement shall not be affected thereby and shall remain in full force and effect.

I further agree that this Agreement supersedes any previous and/or contemporaneous verbal agreements in regard to my participation in the volunteer effort and cannot be changed an/or amended unless in writing.

By: _____________________________________________________ Date: ____________________________

Print Name: ______________________________________________