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LMC Volunteer Service Program Registration Form

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LMC Volunteer Service Program Registration Form

Note: Required fields are marked with an asterisk (*)

User Profile
E-Mail*:
LMC ID:
First Name*:
Last Name*:
Category:

Contact Information
Address 1:
Address 2:
City:
State:
Zip:
Cell Phone: ()    - 
Home Phone*: ()    - 

Background
Date of Birth (MM/DD/YYYY)*:
Ethnicity:
Gender:    
Major:
Reason for Volunteering:
How Did You Learn of
LMC Volunteer Service:

Preferences
Times Available:
Preferred Location:

Release Waiver
 
ALL PARTICIPANTS IN VOLUNTARY SERVICE ACTIVITIES AND PROGRAMS ARE REQUIRED TO READ AND SIGN THE RELEASE WAIVER OF LIABILITY AND COVENANT FORM BELOW:

I acknowledge that I am solely responsible for any hospital or other costs arising out of any bodily injury or property damage sustained through my participation in such voluntary community service activities. I have read it and understand. I accept and assume all risks, hazards, and dangers involved in any such activities in which I may elect to participate, including the training and preparation for and travel to and from the site of such activities.
 
RELEASE WAIVER OF LIABILITY AND COVENANT NOT TO SUE
READ CAREFULLY BEFORE SIGNING

The undersigned hereby acknowledges that participation in voluntary community service activities involves inherent risks of physical injury, illness or loss of personal property and assumes all such risks. The undersigned hereby agrees that for the consideration of Lake Michigan College (LMC) allowing the undersigned to participate in volunteer community service activities sponsored or recommended by LMC, the undersigned participant does hereby waive liability, release and forever discharge the Institution of LMC and the Board of Trustees, its members individually, and its officers, and employees of and from any and all claims, demands, rights and causes of action of whatever kind or nature, arising out of all known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property and the consequences thereof, including death, resulting from my voluntary participation in or in any way connected with such voluntary community service programs and activities.

I further covenant and agree that for the consideration stated above I will not sue Lake Michigan College, the Board of Trustees, its members individually, its officers, or employees for any claim for damages arising or growing out of my voluntary participation in community service programs or activities.

I understand that the acceptance of this release, waiver of liability and covenant not to sue Lake Michigan College or the Board of Trustees or any agent or employees thereof, shall not constitute a waiver, in whole or in part, of sovereign of official immunity by said Boards, its members, officers, and employees.

Further, I understand that this release, waiver of liability, and covenant not to sue shall be effective during the time period of the service activity while I am enrolled or employed at LMC. I have received a copy of this document and I certify that I am * years of age and suffering under no legal disabilities and I have read the above carefully before signing.

E-Sign*:    
Date (MM/DD/YYYY)*:



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