Background Certification: I certify that all of the information provided on my application is true and complete. I authorize the YMCA of Montclair (“YMCA”) to investigate and verify any and all of the information I have submitted. Because the YMCA strives to provide a safe environment for children and youth, I understand that the YMCA may order a criminal history check, and I authorize this investigation. 

Volunteer Terms: I agree to abide by the YMCA’s policies, procedures, and Code of Conduct. I understand the YMCA does not provide any health benefits (i.e. medical, dental, workers compensation, etc.) or any accident insurance for me as a volunteer; I understand it is my responsibility to provide this coverage. I understand that the YMCA does not provide volunteer compensation or trade volunteer services for membership or program fees.

Property Loss: I understand the YMCA is not responsible for my personal property lost, damaged or stolen while participating in YMCA volunteer activities.
 
Medical Treatment: I give permission for YMCA representatives to provide or arrange for emergency care for me, and to arrange for transport to an emergency center for treatment. I consent to medical treatment deemed immediately necessary or advisable by a physician if I am unable to act on my own behalf. I further understand that the YMCA is not responsible for payment for such medical treatment.

Release from Liability:  I acknowledge and agree that any use of YMCA and Montclair facilities, services, equipment, and premises ("Facilities") and any participation in YMCA of Montclair programs and activities ("Programs") comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease. I voluntarily, for myself and my child, accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in the Programs. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this form.

I hereby give permission for my image, captured during YMCA of Montclair events through video, photographic, digital, electronic or any other media together with or without my name and hometown, to be used in YMCA of Montclair and YMCA of the USA promotional material and publications (including release to the news media), and waive any rights of compensation or ownership thereto.

I hereby release and hold harmless the YMCA of Montclair, the YMCA of the USA, their agents and representatives and any third parties involved in the creation or publication of the promotional materials from any liability or claims by me or any third party for violations of my personal, proprietary or privacy rights in connection with the use of such images.