ACKNOWLEDGEMENT & ASSUMPTION OF RISKS
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      First Street PW United Methodist Church and Shalom Zone Community, Inc. (collectively “First Street”) has, as part of its mission, to strengthen the community through meaningful volunteer action.  Included in our activities are volunteer efforts related to disaster relief and recovery (“Recovery Activities”).  Recovery Activities frequently involve significant risks, hazards, and / or dangers, some of which are inherent in the activities and cannot be eliminated or reduced (collectively, “Risks”).  These Risks can cause many kinds of injury and / or loss, including but not limited to loss of property, damage to property, personal injury, illness, physical, mental, or emotional trauma, disability and / or death (collectively, “Injury”)  I understand that First Street believes that it is important for me to be informed of the Risks of Injury.
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      The Risks include, without limitation:<br><br>

    * Living and working in dangerous circumstances, with limited access to medical care and proper sanitation<br>
    * Working with dangerous equipment, which may break, fail, malfunction, or otherwise cause Injuries.<br>
    * First Street Personnel and other volunteers, many of whom are untrained volunteers themselves, must make various judgments and decisions as they conduct the Activities in changing outdoor and indoor environments.  These judgments are, by their nature, imprecise and subject to error.  Consequently, there are risks involved in such decision making and conduct, including, without limitation, the risk that Personnel or other volunteers may misjudge Participants ability or preparedness to perform a given task, or may misjudge weather, terrain, water and / or river level, or may misjudge the necessity of propriety of medical treatment or lack thereof.<br>
    * The potential exists that Participant, Personnel, other volunteers, or third parties may act carelessly, recklessly or generally fail to exercise due care where communication and transportation are difficult and where evacuation and medical care may be substandard or delayed.<br>
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      These and other hazards and dangers may result in Injury to Participant, which includes without limitation, falling, being struck, dismembered, or crushed, colliding with objects or people, experiencing vehicle collisions, being injured or sickened by machinery, objects, animals, water, mold, or people (collectively, “Injury). <br>
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      I understand that the above description of Risks and Injuries is not complete and that other unknown or unanticipated risks, hazards, and dangers may result in Injury or other loss.  I acknowledge that participating in the Recovery Activities may require a degree of skill and knowledge different from other activities and that I have responsibilities as a Participant.  I warrant that I have no mental or physical problems or limitations that might compromise or affect my ability to participate in Recovery Activities, and I represent that I am fully capable of participating in these activities without causing harm to others or myself.  I acknowledge that First Street and First Street Personnel are, and have been available, to answer any and all questions I may have had about the nature and physical demands of these activities and the risks, hazards, and dangers associated with these activities.  I understand that presence of any First Street Personnel is no assurance of my safety or any lessening of the Risks, and I nonetheless undertake to participate in the Recovery Activities.<br>
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      My participation in the Recovery Activities with First Street is purely voluntary and I choose to participate with full knowledge of the Risks.  Therefore, in exchange for being allowed to participate in the Recovery Activities, I assume and accept full responsibility for myself, for those Risks identified here and for those risks not identified, and for all Injury, death, property loss or expenses suffered by myself or by any third party arising out of those Risks and / or my own negligence or (to the extent allowed by applicable law) the negligence of First Street or others. <br>
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RELEASE & IDEMNITY<br>
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      I HEREBY AGREE, ON BEHALF OF MYSELF AND MY CHILDREN, HEIRS, EXECUTORS, ADMINISTRATORS, AND REPRESTATIVES, TO THE FULLEST EXTENT ALLOWED BY APPLICABLE LAW, TO RELEASE, INDEMNIFY AND DEFEND First Street and any and all of its volunteers, employees, board members, contractors, partners, donors, and associates (“First Street Personnel”) with respect to all claims, liabilities, losses, suits or expenses (including costs and reasonable attorneys fees) made or brought by anyone, including myself, and co-Participant, volunteer, third party, or any members of my family arising out of any injury, damage, death, or other loss in any way connected with my participation in Recovery Activities or use of First Street equipment or facilities.  This agreement includes any losses claimed to be caused, in whole or in part, by the negligence of First Street or First Street Personnel.  I agree to waive all claims against First Street or First Street Personnel, whether legal or equitable, and I agree that neither I, nor anyone acting on my behalf, will make claim or file a lawsuit of any kind against First Street or First Street Personnel as a result of any injury, damage, death or other loss.<br>
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      I agree that this and all other aspects of my relationship with First Street are governed by Louisiana State law.  Further, any mediation, suit, or other proceeding arising out of or relating to my participation in Recovery Activities, must be filed exclusively in the State of Louisiana, and Louisiana State law shall apply.  I agree to settle any dispute that cannot be settled by discussion through mediation before a mutually acceptable Louisiana mediator.  I also agree that if I, or someone on my behalf, asserts a claim or files a suit against First Street or First Street Personnel, I will pay all costs and attorney’s fees incurred by Fist Street in defending that claim or suit, if the claim or suit is withdrawn or dismissed, or to the extent a court determines that First Street and / or First Street Personnel is not responsible for the injury or loss.<br>
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      While I agree that First Street has no responsibility to provide medial care to me and makes no offer to do so, I authorize First Street Personnel, should they deem it necessary, to obtain or provide such medical care for me as they deem appropriate, and / or to transport me to a medical facility should they deem it appropriate.  I further authorize Personnel or any medical personnel to render such treatment they deem necessary for my health.  I further agree to pay all costs associated with such care or evacuation whether or not authorized by me.  Without limiting any of the foregoing, I expressly waive any claims that I or anyone on my behalf may make against First Street or First Street Personnel with regard to medical care and the provision or failure to provide such care. <br>
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PHOTO RELEASE<br>
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      I hereby authorize and consent that First Street may copyright, publish, use, sell or assign any and all photographic portraits or pictures, television spots, movie films, videotapes and / or sound records or any part thereof, that they may have taken or made of me in which I may be included in whole or in part, whether separate from or in connection with illustrative or written manner, story or news item, motion pictures, television or radio spots, or for publicity, advertising or any other lawful purpose whatsoever, in conjunction with my name or in anonymity.  I hereby waive any right I may have to inspect and / or approve the finished product or the advertising copy that may be used in connection wherewith or the use to which it may be applied. <br>
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      Any portion of this Document deemed unlawful or unenforceable shall not affect the remaining provisions of the Document, and those remaining provisions shall continue in full force and effect.<br>
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      I have carefully read this document, I understand it, and I voluntarily sign it and acknowledge that it shall be effective and legally binding upon myself, my family, heirs, executors, representatives and state, and that no oral representatives, statements or inducements apart from the Release have been made to me.