Parent/Guardian Volunteer Consent

(Required for all youth volunteers under 18 years of age)

In order for your child to become a volunteer or intern with us, we need your consent and involvement in helping them have a productive experience. Please read and sign this parental consent form if you would like TOSS to continue the process of considering your child as a volunteer.

Note: This Parental Consent Form must be filled out for all volunteers/interns under age 18. Children under the age of 14 may not volunteer at TOSS.

Volunteer Consent Details

I understand that my child (named below) wishes to be considered for volunteer/intern work and I hereby give my permission for him/her to serve in that capacity, if accepted by TOSS.
I understand that he/she will be provided with any training necessary for the safe and responsible performance of his/her duties and that he/she will be expected to meet all the requirements of the position, including regular attendance and adherence to TOSS's policies and procedures.
I understand that he/she will not receive monetary compensation for the services contributed.

Media Consent Details

I hereby give and forever grant to TOSS and The Industrial Commons (hereafter “TIC”), its advertising agency, licensees, consultants, producers or publishers of its promotional materials and their successors and assigns, the right to use, publish, copyright, record, videotape, and/or photograph my image, picture, portrait, likeness, and/or voice, in whole or in part, including alterations, modifications, derivations, and components thereof in any media (whether currently existing or yet to be developed) for any lawful purpose, including, but not limited to, advertising, marketing, and promotion of TIC and its products throughout the world. This right shall include the right to combine my likeness with others and to alter my likeness, by digital means or otherwise, for the purposes set forth herein. I understand that TIC’s use of my image, picture, portrait, or likeness may or may not include my name. I understand that TIC makes attempts to outreach to individuals and ask about specific uses of images; however, I also understand that there may be times when I may not be informed in advance of the specific use of my image.
The Industrial Commons utilizes video surveillance in our building located at 647 Hopewell Road for the purpose of ensuring the safety and security of all attendees, participants and staff. All video recordings are securely stored and accessed only by authorized personnel for security purposes. The recorded footage will not be used for any other purpose without explicit consent or as required by law. I release the event/organization and its agents, employees, and partners from any liability related to the use of video surveillance and the capture of images and videos during the event. I understand that the organization is not responsible for any unauthorized use of images or videos captured by other individuals.
By signing below, I acknowledge that I have read and understood the terms of this Video Surveillance Notice and Media Release Form. I voluntarily agree to be bound by its terms.

Youth Volunteer Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Relationship to the Volunteer

Parent/Guardian Email

Parent/Guardian Phone

(###)

###

####

Consent

I consent for my Youth to Volunteer at TOSS

I consent for my Youth to be photographed/videoed while volunteering

Parent/Guardian Signature

First Name

Last Name

Hold Harmless Agreement

Read the following Hold Harmless agreement and sign on behalf of your youth volunteer if you agree to the terms: I acknowledge and affirm that I have the opportunity to ask any questions I may have of TOSS or The Industrial Commons personnel prior to beginning volunteer service and prior to the commencement of my volunteer work. I also acknowledge that, despite any answers I have received with respect to my inquiries, the conditions and circumstances of my volunteer service may change to meet the demands of the project. I understand that my volunteer service shall remain at the will of TOSS and The Industrial Commons and may be terminated at any time for any reason. If at any time I conclude that I am physically or emotionally incapable of performing a task or enduring the conditions existing during my volunteer service, I understand that it is my sole responsibility to inform TOSS and The Industrial Commons personnel that I cannot or will not perform an assigned task or that I cannot or will not continue to endure the conditions of my volunteer service. Should I elect to perform a task after informing TOSS and The Industrial Commons personnel or volunteers of my reservations about performing the task, I fully acknowledge that the decision to do so is my own, free from pressure or duress by any person. I understand that I am free to end my volunteer service at any time, without reservation or penalty of any kind. I agree that my decision to perform an assigned task is my certification that I am physically and/or emotionally capable of performing the assigned task despite any prior representations I may have made regarding my physical and/or emotional health. I hereby agree, on behalf of myself and my children, heirs, executors, administrators and assigns, to the fullest extent allowed by applicable law, to release, indemnify and defend TOSS and The Industrial Commons and any and all of its volunteers, personnel, board members, contractors, partners, donors and associates (each an “The Industrial Commons Indemnitee”) with respect to all claims, liabilities, losses, suits or expenses, including all litigation costs and attorney’s fees, brought by anyone, including me, in connection with my participation in TOSS and The Industrial Commons projects. By this agreement I agree to waive all claims, whether legal or equitable, for losses, including property damage or bodily injury sustained in connection with use of my motor vehicle or any other motor vehicle in connection with TOSS or The Industrial Commons projects, that I may claim to be caused, in whole or in part, by the negligence or other wrongdoing of any The Industrial Commons Indemnitee. I authorize TOSS and The Industrial Commons and its employees, contractors, and representatives to make photographs, films, and other visual and audio recordings of me during my volunteer service (collectively, “Recordings”) and to publish, display, distribute, and otherwise use the Recordings in print and/or electronic form in any and all media, with or without my name and for any lawful purpose. The foregoing rights include, without limitation, the rights to sell, license, or assign any and all photographic portraits or pictures, television spots, movie films, videotapes and/or sound recordings, or any part thereof, that may incorporate all or part of such Recordings. I hereby waive any right I may have to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith or any other use to which the Recordings may be applied. I authorize The Industrial Commons to seek and obtain medical care for me should its personnel deem it necessary to do so. I agree to hold harmless any and all persons who seek or obtain my medical care. With respect to any medical expenses not covered by The Industrial Commons policy, or which is deemed ineligible by The Industrial Commons’ carrier, I agree to assume full responsibility for the cost of all such medical services. I agree that this agreement shall be governed by North Carolina law, without reference to principles of conflicts of laws. Any legal action I may take, despite the terms of this agreement, shall be brought in North Carolina. Before bringing any legal action for any claim I may make, I agree to participate in mediation in North Carolina with a North Carolina-based mediator mutually acceptable to the parties. If mediation should fail to resolve any claim I may make, I agree to engage in binding arbitration in North Carolina under the rules and regulations of the American Arbitration Association and before an arbitrator approved under its rules and regulations mutually acceptable to the parties. Should any claim I may make be dismissed or withdrawn, either in arbitration or in a court proceeding, I agree to pay all the costs and attorney’s fees incurred by The Industrial Commons, its personnel or volunteers. Should any portion of this agreement be determined to be unenforceable, the remaining portions of the agreement shall remain in full force and effect without modification. I give my consent to TOSS and The Industrial Commons to conduct a full and complete background investigation of me at any time in connection with my volunteer service. I have read this agreement, or in the event I am unable to read this agreement by reason of language and/or understanding, I have independently undertaken to have it read to me or translated for me, and I acknowledge that I have voluntarily signed it, and that no oral or written representations, statements, or inducements apart from the terms of this agreement have been made to me in signing this agreement. I further agree that no prior or contemporaneous oral or written statement may be used by me to modify the terms of this agreement nor may this agreement be modified in any respect following the date of my signature except by way of a written modification agreement with The Industrial Commons. I understand that this agreement is subject to TOSS and The Industrial Commons’ privacy policy, which assures me that The Industrial Commons will not share my personal information with anyone outside the organization without my permission. Additionally, I have been assured that all information regarding me, whether collected online or in person, is collected via secure channels and stored in The Industrial Commons’ secure databases and facilities subject toThe Industrial Commons’ privacy policy. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. The Industrial Commons has put in place preventative measures to reduce the spread of COVID-19; however, The Industrial Commons cannot guarantee that you will not become infected with COVID-19. Further, volunteering with The Industrial Commons could increase your risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I may be exposed to or infected by COVID-19 by attending the TOSS and The Industrial Commons volunteer program and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I also agree to comply with all federal, state and local mandates, as well as any policies of The Industrial Commons, relating to social distancing, hygiene, cleaning and disinfection and any required health screenings. I agree to stay home if I have been exposed to COVID-19 in the past 14 days, am not feeling well or am displaying any symptoms of COVID-19. I also agree to immediately notify the The Industrial Commons if I experience any of the foregoing while on program. I understand that the risk of becoming exposed to or infected by COVID-19 on the The Industrial Commons program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, The Industrial Commons employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with attendance on the The Industrial Commons program. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless The Industrial Commons, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence ofThe Industrial Commons, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any The Industrial Commons program.