Volunteer Liability Release Form

Volunteer Liability Release Form

I would like to volunteer for the Broome County Council of Churches Inc. I understand that I am responsible for my own medical insurance and will not hold Broome County Council of Churches Inc. liable for any injury or damage to myself, or my property, while volunteering at the Broome County Council of Churches.

Volunteer Liability Release Form

Please fill out online or print out an application form here

Volunteer Liability Release Form

  • By typing my name above I am providing my electronic signature which represents and is equal to my physically written signature
  • Emergency Contact Information

  • Parental Consent (If participant is under the age of 18)

    I give permission for my child to serve as a volunteer for the Broome County Council of Churches. In the event my child requires any medical care while serving with the Council, and I am unavailable,
  • authorizes any doctor or hospital to provide such treatment as that individual determines would be appropriate to care for the condition with which the minor presents to said doctor or hospital. The Broome County Council of Churches shall not be liable for any health care, which its representative authorizes,as long as such care is recommended by the hospital or the doctor.I understand that I am responsible for this minor’s own medical insurance and will not hold the Broome County Council of Churches Inc., or any of its agents, liable for any injury or damage to this minor while volunteering for the Council.
  • By typing my name above I am providing my electronic signature which represents and is equal to my physically written signature
  • This field is for validation purposes and should be left unchanged.
Broome County Council of Churches Inc.

3 Otseningo Street
Binghamton, NY 13903
607.724.9130
mail@broomecouncil.net

Stats

people served in 2018

BC Council of Churches has received the prestigious Charity Navigator 4-star rating for sound fiscal management & commitment to accountability & transparency. Click here to view full rating.


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