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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />Contract# IRL2024N-08 <br />Encumbrance# GLO1-2309 <br />ATTACHMENT C <br />INDIAN RIVER COUNTY Volunteer Sign-up and Release of Liability Form <br />To be signed by all persons engaging in volunteer activities on the date of the activity <br />Date: , Project: <br />By my signature below, I acknowledge I am over the age of 18, and acknowledge and agree to the <br />following: <br />(1) I certify that I have no medical conditions or restrictions that would prohibit me from acting <br />as a volunteer. INDIAN RIVER COUNTY ("IRC") and the IRL Council ("COUNCIL") do <br />not assume any responsibility for evaluating my medical condition or determining my fitness <br />to perform volunteer activities. I must comply with all IRC and COUNCIL policies and <br />regulations, including safety guidelines. <br />(2) I am not a volunteer for the COUNCIL, and I am not an employee of IRC or the COUNCIL. <br />At all times I am acting as an unpaid, independent volunteer, and as such, am not entitled to <br />any provision of law regarding IRC or COUNCIL employment; nor any laws relating to <br />hours of work, rates of compensation, leave time or employee benefits. <br />(3) I recognize and understand that I am at all times responsible for my own safety and the safety <br />of others, and that in performing volunteer activities I may encounter natural or other hazards. <br />I assume the risk of any such hazards and recognize that I am responsible for staying alert as <br />to potential hazards and taking appropriate steps, including discontinuing any activities that <br />involve a risk of bodily harm. <br />(4) I understand that I am volunteering for a project under the sole operation and control of the <br />IRC. The Council is merely a funding entity and has no control over the conditions, tasks, or <br />methods by which the volunteer activities are conducted. <br />(4) I hereby hold and save IRC and the COUNCIL, its directors, officers, employees and <br />representatives, harmless from, and agree to indemnify same against, any and all claims and <br />losses that may be made by me or my heirs, spouse, or other persons, for personal injury, loss <br />of life, or property damage that may result from my participation as a volunteer. This waiver <br />and indemnity obligation include claims based upon my partial or sole negligence or that of <br />IRC and COUNCIL. <br />Page 23 <br />