HelpOki Liability Waiver and Volunteer Application

MEMBERS, GUESTS, AND VOLUNTEERS SHOULD COMPLETE THIS FORM. A PARENT / LEGAL GUARDIAN’S SIGNATURE IS REQUIRED IF PARTICIPANT IS UNDER AGE 18. In return for being permitted to volunteer and/or participate in HelpOki’s activities, including any activities incidental to such participation (hereinafter “Organizational Activities”), the undersigned Participant, or Parent/Legal Guardian of a minor Participant (hereafter referred as “I”, “me”, or “my”) releases and agrees not to sue HelpOki or its Officers, Directors, Members, employees, sub-contractors, sponsors, agents, and/or other volunteers (collectively “HelpOki”) from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property damage, sickness, personal injury, or wrongful death arising as a result of my participation in the Organizational Activities wherever, whenever, or however the same may occur. I hereby freely and voluntarily, without duress, execute this Waiver under the following:

Waiver and Release

I, the Participant, understand that participation in the Organizational Activities involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the Organizational Activities with knowledge of the danger involved and I agree to accept all risks of participation. I release and forever discharge and hold harmless HelpOki and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my participation with HelpOki and its events.

Insurance.

I, the Participant, understand that I expressly waive any such claim for compensation or liability on the part of HelpOki beyond what may be offered freely by the representatives of HelpOki in the event of such injury or medical expense. I also acknowledge that HelpOki has not arranged and does not carry any insurance of any kind for my benefit or that of Volunteer (if Volunteer is under 18), my parents, guardians, trustees, heirs, executors, administrators, successors and assigns. I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Organizational Activities.

Medical Treatment.

I hereby release and forever discharge HelpOki from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my time with HelpOki.

Assumption of the Risk.

I understand that my time with HelpOki may include activities that may be hazardous to me, including, but not limited to, driving automobiles and/or other moving vehicles, construction activities, and loading and unloading of heavy equipment and materials. I hereby expressly and specifically assume the risk of injury or harm in these activities and release HelpOki from all liability for injury, illness, death, or property damage resulting from the activities of my time with HelpOki. I also agree to indemnify and hold harmless HelpOki for all claims arising out of my participation in the Organizational Activities.

Other.

I expressly agree that this Waiver is intended to be as broad and inclusive as permitted by the laws of Japan, and that this Waiver shall be governed by and interpreted in accordance with the laws of Japan. I agree that in the event that any clause or provision of this Waiver shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable. I also understand that this document is a contract which grants certain rights to and eliminates the liability of HelpOki.

PHOTOGRAPHIC RELEASE.

I grant irrevocably and absolutely to HelpOki all right, title and interest in any and all photographs, video or audio recordings of me or including my image or voice whether original or altered in any way (collectively “Photographs”), that are made by HelpOki during my Organizational Activities with HelpOki including, but not limited to, the right to use the Photographs for any purpose whatsoever in any form and to any royalties, proceeds or other benefits derived from them.

First Name

Check here is participant is under 18.

Last Name

Address

Phone Number

EMERGENCY CONTACT INFORMATION

Name

Relationship to Participant

Phone Number

HAVE READ THIS FORM AND UNDERSTAND THAT BY SIGNING BELOW I AM GIVING UP LEGAL RIGHTS AND REMEDIES. I AM SIGNING THIS FORM FREELY AND WILLINGLY.

Your Signature

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Date

Printed Name

On Behalf Of

Choose (if applicable)

Parent

Participants Guardian

Special Training, Skills, Hobbies:

Groups, Clubs, Organization Memberships:

Prior Volunteer Experience:

Why do you want to volunteer? (What do you hope to gain from this volunteer experience?)

What experiences have you had that may prepare you to work as a volunteer in the field of (description of field)?

Have you ever been convicted of a crime? (If yes, please explain). Conviction of a crime is not an automatic disqualification for volunteer work).

Do you have a car for transporting others?

Please read the following carefully before signing this application: I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with HELP OKI® that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by HELP OKI®. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with HELP OKI® or my termination as a volunteer. I understand that any donations provided to HELP OKI will be the property of HELP OKI® to distribute/sell/refurbish as they see best for those most in need.