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1 This Release and Waiver of Liability (the "Release"), executed on this day of, 20 ( / / ), by (the "Volunteer") in favor of Mon County Habitat for Humanity, Inc., a nonprofit corporation ("Habitat"), its directors, officers, employees and agents, indicates that the Volunteer desires to participate and work in Habitat's home building program, and the activities related to the work. The Volunteer understands that the activities may include constructing and rehabilitating residential building, being transported to and from work locations, consuming food and utilizing living accommodations donated for the work. The Volunteer does hereby freely, voluntarily, and without duress execute this Release under the following terms: 1. Waiver and Release: Volunteer does hereby release and forever discharge and hold harmless Habitat and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from Volunteer's participation in Habitat's home building program. Volunteer understands that this Release discharges Habitat from any liability or claim that the Volunteer may have against Habitat with respect to any bodily injury, personal injury, illness, death, or property damage that may result from Volunteer's participation in Habitat's home building program. Volunteer also understands that Habitat does not assume responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance. 2. Medical Treatment: Volunteer does hereby release and forever discharge Habitat from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connections with the Volunteers' participation in the Habitat program. 3. Assumption of Risk: The Volunteer understands that the Habitat program may include activities that may be hazardous to the Volunteer and that the food, accommodations, and medical facilities may be donated to Habitat and beyond its control. Volunteer hereby expressly and specifically assumes the risk of injury or harm in these activities and releases Habitat from all liability for injury, illness, death, or property damage resulting from the activities of the Volunteer's participation in Habitat's program. 4. Insurance: The Volunteer understands that Habitat strives to maintain a safe working environment and in the event of an accident where the volunteer incurs medical expenses, Habitat's insurance will cover, up to certain limits, only those expenses not covered by the Volunteers primary insurance. Habitat does not carry any disability insurance for any volunteer. Each Volunteer is expected and encouraged to arrive with medical or health insurance coverage in effect. 5. Photographic Release: Volunteer does hereby grant and convey unto Habitat all right, title, and interest in any and all photographic images and video or audio recordings made by Habitat during Habitat's home-building program, including, but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings. 6. Other: Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of West Virginia, and that this Release shall be governed by and interpreted in accordance with the laws of the State of West Virginia. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable. Volunteer has executed this Release as of the day and year first above written. Volunteer Signature Print Volunteer Name Page 1 of 5

2 What is Habitat for Humanity? Habitat for Humanity International is a nonprofit, ecumenical Christian housing ministry that seeks to eliminate poverty housing and homelessness from the world and to make decent shelter a matter of conscience and action. Through volunteer labor, management expertise, and donations of money, materials, and land Habitat builds homes with the help of the homeowners. The homes are then sold to the partner families at no profit on an interest-free mortgage. Habitat for Humanity International was founded in The local affiliate, Mon County Habitat for Humanity, was founded in How big is Habitat for Humanity? There are approximately 2100 Habitat affiliates operating in every state and in nearly 90 countries. Since 2008 these affiliates have completed more than 300,000 homes worldwide. In 2011, Mon County Habitat will complete its 39 h house. Where does the money come from? We raise much of the money for our program in Monongalia County, our local funds come from individuals, faith communities, businesses, civic organizations, and fund-raising events. We also look to grants from outside of our community as well as some government funding. How are partner families selected? Families apply to Habitat and the family selection committee makes partner recommendations to the board of directors. Families are chosen based on their need, income, willingness to partner. We follow the guidelines set forth in the Fair Housing Act and Equal Credit Opportunity Act. What is required of a partner family? Habitat is not a giveaway program, but a joint venture in which those who benefit from the program are involved in the work. Family members 18 and older, who will be living in the home, are required to invest 250 hours of sweat equity in the construction of their home. Together, we build simple, decent, affordable homes. What does a Habitat house cost for a partner family? We sell the home for the cost of the materials, including a valuation for donated materials and land. Donated professional services are not included in the cost figure. Mortgages typically run about $65,000 (depending on size) and are assessed for around $135,000. Measures are taken to ensure that the costs of the utilities are not prohibitively expensive. We use energy star appliances, and have adopted a green building policy to ensure energy efficiency. Please sign after reading. Page 2 of 5

3 Basic Construction Site Safety Rules 1. Dress appropriately for the work site. Appropriate dress includes closed toe, closed sole shoes as well as appropriate clothing. 2. Wear personal protective equipment when appropriate. Hard hats, safety glasses and gloves are provided and you are encouraged to wear them. 3. THINK before you do your task. 4. If you are uncertain about how to do a task or operate a tool ask a supervisor. 5. Concentrate on your task and eliminate distractions. 6. Know where the first aid kit is located and how to get emergency help. 7. Advise your supervisor immediately of any unsafe or hazardous power tool or condition. 8. If any task makes you feel uncomfortable, do not do it. 9. Know where the first aid kit is and who your first aid person is on site. 10. If you have any questions at all, ask. Please sign after reading the above rules. Volunteer Signature Print Volunteer Name Page 3 of 5

4 Emergency Contact Information Please take your time and fill this out completely! Your safety is our priority! In case of emergency, please contact: Name: Relation: Address: Phone: (primary) (alternate) Emergency Medical Information: (May be needed by any hospital or medical practitioner not having access to the Volunteer's medical history) Allergies: Medications being taken: Date of last Tetanus shot: Personal Physician Name: Address: Phone: (day) (eve) Health Insurance Provider: Agent: Policy #: Physical limitations: Other: Page 4 of 5

5 ADULT VOLUNTEER INFORMATION Address: Phone: (primary) (alternate) What is your preferred method of contact? (Circle one) phone address Are you an: Adult College Student High School Student Age: Did you come with a group? Y N Name of group: Would you like to receive our newsletter? (3/year) electronic print Would you like to receive our monthly announcements? Yes No How would you like to volunteer with us? -This section is for those who would be interesting in volunteering more in the future- Helping on the construction site Work in ReStore Helping in the Office Become a construction site Crew Leader Join a committee Construction Family Selection Family Advocacy Faith Relations Property Fundraising Communications Join the WVU Campus Chapter of Habitat for Humanity Join Youth United, the Habitat for Humanity club for youth ages 5-25 My church might be interested in sponsoring a Habitat home. Please contact the following church and or person: Please list any special skills you can offer or areas of interest to you: Page 5 of 5