Sign up to Volunteer at LGSUHSD Fall Screening

Volunteer for LGSUHSD Winter Screenings
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Waiver Statement:

Volunteer Waiver of Liability

The Volunteer desires to work as a volunteer for Kyle J. Taylor Foundation and engage in the activities related to being a volunteer (the “Activities”). The Volunteer understands that the Activities may include youth heart screening events, fundraising events and Sudden Cardiac Arrest Awareness events.

The Volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms:

Release and Waiver: Volunteer does hereby release and forever discharge and hold harmless Kyle J. Taylor Foundation and it 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 Volunteer’s Activities with Kyle J. Taylor Foundation.

Volunteer understands that this Release discharges Kyle J. Taylor Foundation from any liability or claim that the Volunteer may have against Kyle J. Taylor Foundation with respect to any bodily injury, personal injury, illness, death, or property damage that may result from the Volunteer’s Activities with Kyle J. Taylor Foundation, whether causes by the negligence of Kyle J. Taylor Foundation or its officers, directors, employees, or agents or otherwise. Volunteer also understands that Kyle J. Taylor Foundation does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness.

Medical Treatment: Volunteer does hereby release and forever discharge Kyle J. Taylor Foundation from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with Kyle J. Taylor Foundation.

Assumption of the Risk: The Volunteer understands that the Activities includes work that may be hazardous to the Volunteer, including, but not limited to, construction, loading and unloading, and transportation to and from the work sites.

Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases Kyle J. Taylor Foundation from all liability for injury, illness, death, or property damage resulting from the Activities.

Insurance: The Volunteer understands that, except as otherwise agreed to by Kyle J. Taylor Foundation in writing, Kyle J. Taylor Foundation does not carry or maintain health, medical, or disability insurance for any Volunteer.

Each Volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.

Photographic Release: Volunteer does hereby grant and convey unto Kyle J. Taylor Foundation  all rights, title, and interest in any and all photographic images and video or audio recordings made by Kyle J. Taylor Foundation during the Volunteer’s Activities with Kyle J. Taylor Foundation, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Other: Volunteer expressly agrees that this Release in intended to be as broad and inclusive as permitted by the laws of the State of California and that this Release shall be governed by and interpreted in accordance with the laws of the State of California. Volunteer agrees that in the event that any clause or provision of this Release 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.

Volunteer Privacy Agreement Form

As a Kyle J. Taylor Foundation volunteer, you may have access to confidential information related to one or more of our screening participants. To ensure the privacy of those who attend our heart screenings, and to comply with all State of California and federal privacy laws, Kyle J. Taylor Foundation requires all volunteers to read and acknowledge the following:

1) It is illegal for you to use or disclose a screening participant’s Confidential Information (as defined below), either verbally or in written form, outside the scope of your volunteer duties at Kyle J. Taylor Foundation.

2) All data and personal information, including but not limited to contact information, of each participant (“Confidential Information”), is to be viewed only by those volunteers who have a NEED TO KNOW such Confidential Information for the purposes of meeting the objective of the heart screening.

3) Guidelines for use of Confidential Information:

a) Access the minimum amount of information necessary to carry out your volunteer assignment.

b) You may use this Confidential Information as necessary in the contact with screening participants.

c) Do not make any copies of participant information.

d) Do not photograph participants.

e) Do not record patient names, date of birth, address, phone number, number, etc., on any forms or papers other than those provided to you by the Kyle J. Taylor Foundation.

f) You may only access the Confidential Information of screening participants when there is a need for you to know that information.

g) Be aware of your surroundings when discussing Confidential Information. It is inappropriate to discuss information about a screening participant where others may overhear you (other than in the normal course of the screening).

h) If you have questions about the use or disclosure of Confidential Information, contact Kyle  J. Taylor Foundation.

i) When disposing of any documents with screening participant information, do not put into a waste can.

4) All who attend the screening are entitled to their privacy. Nothing you see, hear, or observe as a volunteer can be shared with anyone for any reason, unless you are part of the screening team for that participant. This includes the fact that the individual participated in the screening.

5) Kyle J. Taylor Foundation takes Confidential Information and participant privacy very seriously, and we require all volunteers to protect the privacy of those who are screened with the greatest care and respect.

By clicking the "Yes I agree" box you are confirming you are over 18 or the legal guardian of the minor above and I accept the terms of the waiver.

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