Youth Waiver Hearts & Hammers Youth Waiver Name of the child* First Last Age: (must be at least 12 years or older)*Volunteer Team*None3MAdvent UMCAdvent Lutheran ChurchAECOMASHRAEASPEAssociative BRC/ Associative BankAuto-Owners InsuranceAzroBig-D ConstructionBerg DrywallBKV GroupBauhaus Brew LabsBurns & McDonnellBWBRCE ContractingCarpenter Evert and AssociatesCatholic Heart Work CampC.G. Hill and SonsCommunity of Minnetonka BeacahCreative HomesCuningham GroupDark Clouds Silver LiningDavis & AssociatesDo Good RosevilleDJ KranzDunhamDunwoodyEgan CompanyFaithful & GouldFederal Reserve BankFinal Coat PaintingFive Oaks ChurchFrana CompaniesGracoGeneral MillsGerdauGood Sam UMCGray Plant MootyGraybarHarris MechanicalHennepin CountyHGA ArchitectsHoly Cross ELCAHorwitz MechanicalHunt ElectricHumanaIREMInnovative Building & DesignImmanuel Lutheran ChurchKeller WilliamsKnutson ConstructionKraus-Anderson ConstructionLeadous GroupLifetouchLord of Life ChurchMcGough ConstructionMERGEMetropolitan EndodonticsMeyer Borgam JohnsonMinneapolis Homeowner NavigationMN Builders ExchangeMMCMNCARMNSEAMortensonMSCANDSU Twin Cities AlumniNotre Dame Alumni ClubO'Keefe WoodOld National BankOlympia TechOpusOptumParsons ElectricPerkins + WillPope ArchitectsPremier BanksRachel Contracting, Inc.Reell ManufacturingRJM ConstructionRotary Club of EdinaRouzerRSP ArchitectsSpirit of HopeStahlSt Peders ChurchSt. Pius XSt. Stephen Presbyterian ChurchSt. ThereseSambatekSchadegg MechanicalSharper ManagementSherwin WilliamsSLCStillwater Sunrise RotaryStinson Leonard StreetSurly Gives a DamnSynchrony FinancialTarget HRTarget FRSTCF BankThe Hammer HouseThrivent FinancialThomson ReutersTee it up for the troopsTorch MinistryTroop 90UW StoutVeit USAViking ElectricVince KingWalkerWestminister Presbyterian ChurchWeek of HopeWestwood Lutheran ChurchName of parent* First Last Parent Email* Parent Phone*Emergency Contact* First Last Emergency Contact Phone*In consideration of the opportunity afforded to my child as a volunteer in a project organized by Hearts and Hammers - Twin Cities, Inc. (H & H), an all-volunteer project to repair and refurbish the homes of low-income disabled and elderly persons, and in light of the aims and purposes of the community service provided by H&H in organizing this project, I give my permission for my child to participate in the project, and I, on behalf of my child and myself, waive any right or cause of action arising out of my child’s participation in the project from which any liability may or could accrue against H & H, its officers and directors or employees, or against all volunteers who contribute labor, materials, and/or equipment to the project, collectively or individually. Without limiting the generality of the foregoing, I, on behalf of my child and myself, agree that this waiver shall include any rights, demands, injuries, damages, claims, actions, or causes of action resulting from personal injury to my child or damage to my child’s property due to any active or passive negligence, or other conduct in connection with my child’s activities for the project, including but not limited to claims arising out of lead-based paint or other hazardous materials, but this waiver shall not apply to conduct that is fraudulent, intentional, or grossly negligent. I also agree that this release is binding on myself and any heirs, executors, administrators and assigns of myself or my child. I recognize that the activities associated with this project are potentially dangerous and could result in serious personal injury or property damage. Nevertheless, I assume on behalf of my child the risk of that injury, whether these risks are known or unknown to me, and I absolve H & H and all affiliate individuals and companies from all responsibility or liability of any description. I also grant to H & H unrestricted permission to use, copy, reproduce, alter, display, distribute, publish and exhibit any pictures, video or narrative in which my child may be included through any means of communication whatsoever for any lawful purpose whatsoever. I further release and discharge, on behalf of myself and my child, H&H from any and all claims arising out of such use. My child and I have both read the attached Safety Guidelines . Parental Agreement* I have read and agree to the Terms and Conditions above Hearts & Hammers - Twin Cities 2599 Fairview Avenue North St Paul MN 55113 651-636-0797 www.heartsandhammers.org
