Your safety is our priority. We expect all volunteers to be following local health guidelines. Please answer the following questions based on your own personal comfort level with risk of transmission:
By signing below, I hereby agree to hold harmless and release the Continuum of Care; its member organizations, their boards/trustees, officials, employees, volunteers, count organizers; and other participants in the Point-In-Time Count, including any homeless individuals subject to the count (together, the "CoC Parties"), from any claims, liability or demands, either in law or equity, for any accident, injury, or death, including any COVID-19 related illness or condition (whether infection occurs before, during, or after participation in the Program), or any theft or loss of or damage to property arising from the participation as a Volunteer in the Point-In- Time Count, regardless of whether incurred as a result of negligence or other.
I understand that there are additional health risks due to the novel coronavirus, COVID-19, which is extremely contagious and believed to spread primarily from person-to-person contact. Having full knowledge of these risks, I voluntarily assume the risk that I may be exposed to or infected by COVID-19 by my voluntary participation in the Point-In-Time Count, and that such exposure or infection may result in personal injury, illness, disability, and death, as well as transmission of COVID-19 to other individuals. I agree to follow federal, state and county public health guidelines while conducting the Point-in-Time Count and participating in any forms of associated Point-in-Time activities. I further agree to self-monitor for signs and symptoms of COVID-19, and to notify the Continuum of Care if I experience symptoms within 14 days after conducting the Point-in-Time Count.
If I am a driver or passenger in a vehicle as part of my participation in the Point-in-Time Count, I understand and agree that accidents can occur as part of a vehicle trip during the Point-In-Time Count and that, as a result, I may sustain serious or fatal injuries or damage to my personal property. I further understand and agree that being in a vehicle with other persons results in a heightened risk that I may be exposed to or infected by COVID-19 and suffer illness or death as a result. I voluntarily assume these and any other risks in participating in the Point-in-Time Count, and expressly waive and discharge in advance all claims and causes of action that I or my successors in interest may have against the CoC parties arising out of my participation in the Point-In-Time Count.
I have agreed to serve as a volunteer for the Point-In-Time Count. I understand that as a volunteer for the Point-In-Time Count it will be necessary for me to handle and process confidential information. I acknowledge that I will keep all information confidential and that it is my responsibility to keep this information confidential even after I end my volunteer duties for the Point-In-Time Count. I understand that I am not to disclose any identifying confidential information and/or records or to engage in casual or informal conversation identifying any individual involved in the count.
I have read and fully comprehend the information pertained in this form and agree to the terms of this release. By signing below, I acknowledge that it is my responsibility to comply with all laws, policies, and regulations concerning access, use, maintenance and disclosure of information made available to me as a volunteer in the Point-In-Time Count.