Volunteer Waiver

The personal information on this form is being collected under the authority of the Municipal Act, 2001 and the Municipal Freedom of Information and Protection of Privacy Act. This information will only be used for the purpose of processing your application for volunteering at this institution. Questions about this collection may be directed to the Manager of Records & Elections, FOI Coordinator at 519-255-6100, Extension 6578.

Participant Information

First Name(Required)

Last Name(Required)

Date of Birth(Required)

Email(Required)

Phone(Required)

Are you filling out the form for a minor, under 18?(Required)

Yes

Parent/Guardian Information

Parent/Guardian Name(Required)

First Name Last Name

Email (if different than above)

Phone (if different than above)

Emergency Contact Information

Name of Emergency Contact(Required)

First Name Last Name

Phone(Required)

Agreement

Please read carefully before signing(Required)

To: The Corporation of the City of Windsor (hereinafter the “City”), its employees, Mayor and Members of Council, volunteers, and volunteer leaders, (collectively the “Released Parties”)

As a Volunteer, in consideration of being granted permission to participate with Windsor Fire & Rescue Services activities, and all other related events (hereinafter collectively, the “Event”), the sufficiency of which is hereby acknowledged, I fully understand and agree to the following:

Assumption of Risks: Participation in the Event involves various risks, dangers and hazards, which all volunteers are required to assume. The Volunteer hereby freely accepts and fully assumes all such risks, dangers and hazards and the possibility of personal injury, bodily injury, death, and property loss resulting from participation.

Release: The Volunteer hereby for itself, its heirs, executors, administrators, or any others who may claim on its behalf, covenant not to sue, and hereby waive, release and discharge the City and the Released Parties from any and all claims of liability for personal injury, bodily injury, death and property loss of any kind or nature, arising out of or sustained in the course of the Volunteer’s participation.

Indemnity: The Volunteer agrees to hold harmless and indemnify the City and the Released Parties from any and all liability, loss, claims, demands, costs and expenses, including reasonable legal fees, due to any personal injury, bodily injury, death or property damage to any third party arising from the Volunteer’s participation in the Event.

Rules: The Volunteer agrees to comply with all rules, instructions, and directions of the Event staff and/or representatives, and as outlined in any written material provided. The Volunteer understands and agrees that a failure to comply with the Rules may result in his/her participation in the Event being terminated with immediate effect and that he/she may be required to remove him/herself forthwith from the Event.

Consent to Use: The Volunteer grants the City, and anyone it may authorize, its consent to use its likeness, voice, words, or any other representation, as well as any works of art it may furnish (collectively, the “Works”) in television, radio, film, print, or in any other form, and the right to reproduce, display, distribute, and record same, to promote the Event and any other future promotions as may be determined by the City. The Works may or may not identify the Volunteer as the subject and/or author, and the Volunteer waives any rights that it may have to inspect or give its approval to the Works.

Personal Items: Volunteers are fully responsible for their own personal items during the Event, including but not limited to any equipment, materials, or personal effects that they may use in the course of their participation and the City and the Released Parties shall not be liable for any loss of or damage to the same.

I AM AWARE OF THE NATURE AND EFFECT OF THIS ASSUMPTION OF RISKS, RELEASE, AND INDEMNITY AND FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I/THE VOLUNTEER HAVE/HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I have read and agree to the statements above.

Please read the Sparky The Fire Dog NFPA Guidelines and Procedures(Required)

A public appearance by Sparky requires responsible behaviour by the costume wearer. When you dress in the costume you have an obligation to maintain the integrity and consistency of the character. Sparky is a registered trademark of the National Fire Protection Association (NFPA) and is representing Windsor Fire & Rescue Services.

APPROPRIATE USES
Sparky costumes may be used for parades and for appearances at schools, fairs, youth group meetings, television appearances, sporting events, community safety events and other functions promoting fire safety.

APPEARANCES
Individuals who wear and use the costume must agree to:
• Not speak during appearances. Conversations or explanations should be carried out by an adult accompanying Sparky.
• Always appear in full costume (helmet, coat, pants, boots and paws).
• Remain anonymous at every appearance and in any publicity connected with an appearance. This includes being photographed without the head.
• The person wearing the costume should not rapidly approach small children, should not pursue interaction with anyone who doesn’t appear to want to engage with Sparky, and should not force Sparky on anyone.
• Appear dignified and friendly. Avoid clowning and horseplay.
• The person wearing the costume must exhibit appropriate animation to be effective. Express sincerity and interest in the appearance by moving paws, head, and legs.
• A person should be assigned to guide Sparky at the elbow in public appearances except when not practical, such as a parade float where space is limited.

COSTUME USE
• A private dressing area is necessary for putting on and taking off the costume.
• Keep costume out of sight before and after use.
• After putting the suit on, someone will inspect the suit. Check for the following: – Are the pant legs over the boots? – Is the coat fastened? – Is the head straight? – Are the paws tucked under the coat sleeves?
• The costume can become hot to the wearer after a short period. Limit appearances to 20-30 minute segments if the temperature is above 75 degrees to ensure personal safety.
• To operate the fans, simply push the black buttons. Fully charged batteries will run for approximately 5 hours. Ensure fans are shut off when not in use.

I have read and agree to the Sparky The Fire Dog NFPA Guidelines and Procedures.

Signature of Volunteer(Required)

Parent/Guardian Signature(Required)

4 + 7 =(Required)

(After entering the correct answer in the box above, the Submit button will appear.)

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