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* 1. Agency Name

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* 2. Agency Primary Contact

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* 3. Agency Primary Contact Email

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* 4. Agency Primary Contact Phone Number

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* 5. Wavier and Liability Release

I understand and agree that United Way of Sheboygan County (UWSC) is not liable or responsible for the volunteers who participate in volunteer-related activities at my organization, including Day of Caring volunteer projects.

By signing this form, I understand and agree that my organization is fully responsible for any injury or property damage arising out of the volunteer activities, even if caused by their ordinary negligence or otherwise.

Volunteers who participate in activities at my organization will agree and sign my own liability and participation waivers, relieving UWSC of all responsibility for the volunteers.

I hereby acknowledge that this consent, waiver, indemnity, release and covenant not to sue is binding on me, my heirs, execu­tors, administrators and assigns.

I have read this document and I fully understand the contents, meaning and impact of this consent, waiver, indemnity, release, and covenant not to sue.

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* 6. Electronic Signature | Type your name and title below to agree to the terms above.

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