Name *

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Address *

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Best Time to Contact *

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Release of Liability Disclosure & Agreement *

Insurance Liability Waiver The Insurance Company representing Without Borders Global Corp. Church & Nonprofit has requested that all volunteers who work or volunteer sign a Waiver of Liability. (Please check off the boxes below as your electronic consent, accepting the following terms.

I, do hereby declare that I am assisting Without Borders Global Corp. located at 34199 Yucaipa Blvd., Yucaipa, CA 92399 on a volunteer basis.

I am working at my own risk and will not hold Without Borders Global Corp. or its Insurance Company liable for any injuries that may incur at their location.

If you are under 18, have your parent/guardian read and accept the terms addressed above by checking off the box.

If you are under 18, have your parent/guardian check off this box as their electronic signature and consent of your volunteer service at Without Borders Global.

Parent/ Guardian/ Emergency Contact Info:

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