United States Corps of Chaplains (USCOC)

Volunteer Service Release Form

This is to certify that I, ________________________________, fully understand  that there are certain hazards to health and life that I could reasonably be  expected to encounter in the performance of my duties with the United States  Corps of Chaplains, hereafter referred to as the USCOC. 

I understand and agree that these hazards could involve, or be related to,  automobile accidents, structural fires, chemical incidents, natural disasters,  scenes of violence, and any and all other conceivable dangerous conditions.  I understand and accept the risks associated with being present at such scenes  and that such risks could potentially lead to personal injury or death. In the  event of the occurence of those eventualities, I hold the USCOC entirely  harmless and without blame.

I understand and agree that I am not covered by any health or life insurance  provided by, or made available by, the USCOC. 

I understand and agree that during any event, gathering, or exercise of the  USCOC or any of its affiliate units, I am solely and completely responsible  for my own actions, safety, and insurance coverage. 

In the event of harm to my property, real or personal, as a result of my  service with the USCOC, I agree to hold the USCOC harmless and without blame.

I agree not to subject the USCOC, or cause the USCOC to be subjected to, any  lawsuit or other legal adversity of any kind whatsoever.

These terms and conditions are understood to extend to any person(s) I might  bring with me to any scene, whether a member of the USCOC or not.


Signature _______________________________ 

Print name _______________________________

Date _____________________________________



READ THIS DOCUMENT CAREFULLY, SIGN, AND RETURN TO:
USCOC HQ, P. O. BOX 390, CLANTON, AL. 35046