Liability Waiver Form

Northern Youth Green Movement’s

Clean-Up Drive

Event Description:
Earth is the only planet that can sustain life, it is made possible by the resources it
generates…but all of these are limited. As of now, Earth’s resources continue to deteriorate due
to unethical human activities. Thus, the Northern Youth Green Movement took the initiative to act
on it. The organization would be conducting a Clean-Up Drive within the locality of Antipolo,
Medellin this July 23, 2022 (Saturday) for 3 hours, from 1PM to 4PM. Activities include
sweeping, picking-up trash, and gathering human litters. Volunteers are obliged to bring brooms,
bolos, trash bag, gloves, and dustpan. Activities will take place outdoors in hot and sunny
conditions, so they are advised to wear a cap, light clothes for the top, and jogging pants/shorts,
and bring extra t-shirts and handkerchief/towel.

In consideration of being allowed to participate in any way in the Clean-Up Drive Program
of Northern Youth Green Movement, its related event, and activities, to be held this July 23, 2022;
I, ______________________________, acknowledge, appreciate, and agree that the risk of
injury from the activities involved in this program is significant. The risks include but are not limited
to: actions of other people including, but not limited to, participants, volunteers, event officials,
and unexpected circumstances such as lack of hydration, weather, and other natural conditions.

Therefore, any injuries I may incur during the activity is not covered by the organization
and they have no liability to me for any direct or indirect loss sustained by myself during the event.

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown,
and assume full responsibility for my participation. I recognize that this Accident Waiver and
Release of Liability form will be used by the host organization, and it will govern my actions and
responsibilities at the said event.

I agree to comply with the rules, and regulations pertaining to the Event and to follow all
reasonable safety instructions provided to me by the Event organizers before, during, and after
the Event.
I certify that I am physically fit and that there are no health-related reasons or problems
which prevents my participation in this activity.

I hereby acknowledge that I have carefully read this Liability Waiver Form, understand the
contents thereof, and am executing it voluntarily of my own free will.

Name: Date:
Age:

_______________________________________
Signature under Printed Name

_______________________________________
Guardian Signature under Printed Name
(If volunteer is aged under 18)

Emergency Contact Person:

Emergency Contact Number: