Volunteer and Empower Lives

Muscular Dystrophy Association, Inc.

Grant of permission and release and waiver of rights

For appearance in photographs and video

If the Participant is a minor: I am the parent or legal guardian of the Participant ("my child").

In consideration of my or my child's (if applicable) participation in the Program, I hereby consent to the publication and use of my or my child's (if applicable) name, likeness, voice, writings, diagnosis and other biographical material (together the "Participant's Likeness") for the purpose of promotion, publicity, advertising, or other manner, by MDA, its agents, licensees or assigns, throughout the world in perpetuity. Use of the Participant's Likeness shall include, but not be limited to, photographs, sound and video recordings, films, broadcasts, brochures, publications, reports, web pages, social media posts, promotional materials or any other audio-visual, electronic, printed, tangible work in any media or format, now known or later developed (the "Materials"). I acknowledge that neither I, nor my child (if applicable), shall have any ownership in or use of the Materials or any right of review or approval regarding the use of the Participant's Likeness in the Materials.

Except for the consideration recited above, I understand that I will not be compensated for my or my child's (if applicable) services rendered in connection with the Materials, but that MDA will be relying on this Grant of Permission and Release and Waiver of Rights (the "Release") in determining to use the Materials. Accordingly, I also hereby release and hold harmless MDA, along with its respective directors, officers, employees, volunteers, chapters, licensees, cooperating entities, agencies, their representatives, heirs, executors, administrators, successors and assigns from any and all claims, demands, or causes of action arising out of the use of the Participant's Likeness, in accordance with the terms of this Release.

This Release shall be governed by the laws of the State of New York.

Muscular Dystrophy Association, Inc.

Liability waiver, assumption of risk and indemnification agreement

Waiver of Liability

In consideration of my (my child's) participation in Muscular Dystrophy Association, Inc. (“MDA”) volunteer activities and all related activities (the “Volunteer Activities”), I, on behalf of myself, (my child), my heirs, personal representatives, and assigns (the “Releasing Parties”), do hereby release, waive, and discharge MDA, its directors, officers, employees, volunteers, chapters, licensees, cooperating entities, agencies, their representatives, heirs, executors, administrators, successors and assigns (the “Protected Parties”) from liability arising from any and all claims, in whole or in part, resulting from the inherent risks of the Volunteer Activities or from the negligence of the Protected Parties to the greatest extent allowed by law.

Assumption of Risk

I understand the inherent risks of the Volunteer Activities.
I have read the previous paragraphs, and I know and understand the nature of the Volunteer Activities. I understand the demands of those activities relative to my (my child's) physical condition, and I appreciate the types of injuries that may occur as a result of the Volunteer Activities and their potential impact on my (my child's) well-being and lifestyle. I hereby assert that my (my child's) participation is voluntary and that I knowingly assume all such risks.

Indemnification

I agree to hold harmless, defend and indemnify the Protected Parties from any and all claims of mine, (my child), my spouse, family members, or others arising from my injury or loss due to my (my child's) participation in the Volunteer Activities, including those arising from the inherent risks of the Volunteer Activities or the negligence of the Protected Parties to the greatest extent allowed by law.

HIPAA

All personal information about clients and volunteers, including but not limited to protected health information as described under the Health Insurance Portability and Accountability Act (HIPAA), as well as their ages, addresses and any other personal information given and received throughout your volunteer assignment(s) must be held in the strictest confidence. All volunteers must protect the confidentiality of all personal information received as a MDA volunteer participant, and will not use or disclose it other than as permitted in writing by MDA. For questions, please contact MDA Chief Privacy Officer at privacyofficer@mdausa.org.

Acknowledgement of Understanding; Severability; Jurisdiction

I have read this Liability Waiver, Assumption of Risk, Indemnification Agreement and MDA's HIPAA Confidentiality Policy and fully understand its terms and agree to comply with its terms. I further acknowledge that I am signing the agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all liability. If any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

This agreement shall be governed by the laws of the State of New York.

The following terms and conditions apply to all MDA volunteers. Please review them carefully.

As a volunteer at MDA:

I acknowledge that I am volunteering of my own free will.
I understand that I will not receive any compensation from MDA, and I have no expectation of receiving compensation or benefits from MDA.
I understand that the volunteer services I am providing will not displace the work of an MDA employee.
I understand that service as an MDA volunteer is not a first step toward employment with MDA.
I acknowledge that both MDA and I have the right to end my volunteer service at any time, for any or no reason.
I agree to always conduct myself in a professional and courteous manner and to follow MDA’s rules and policies as they apply to my volunteer work, and I understand that my work will be supervised by MDA staff.