Adult Event Waiver and Release of Liability

Adult Event Waiver and Release of Liability Waiver

Age 19 and Older

In consideration of the opportunity afforded me to participate on September 18, 2021 referenced above (collectively, the "Activity"), wherever the Activity may occur, I now attest that, after reading this Form entirely and carefully, I acknowledge that my participation in the Activity is entirely voluntary. I further understand and agree as follows:

In light of the aims and purposes of the community service provided by RTKC in organizing this Activity, I, the undersigned, now waive any right or cause of action arising as a result of my participation in any RTKC activity from which any liability may or could accrue against RTKC or its officers and directors collectively or individually. Without limiting the generality of the preceding, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damage to my property sustained in connection with my activities while participating in said RTKC Activity. Further, I agree to hold RTKC, and all persons participating in any RTKC Activity, blameless for any accident while in transport while participating within an RTKC Activity.

I understand that in the case of an illness or injury to myself, an RTKC volunteer will try to phone the emergency contacts provided, and I will allow them to secure medical treatment for those health conditions. If need be, I permit the attending physician to ensure the proper treatment and to hospitalize if necessary. I, the undersigned, release RTKC, RTKC workers, donors/supporters/shareholders of RTKC, and anyone participating on behalf of RTKC from all liability in case of illness or injury at all times while I am volunteering for RTKC. If we do not carry health insurance, then RTKC and its participants are not responsible for the expense of any medical treatment received.
By signing my name below, I also hereby consent to the use of photographs and/or videos of those identified below and/or the statements attached hereto, including my personal name or the firm name, by Rebuilding Together Kansas City and its subsidiary and affiliated companies and their respective dealer and distribution organizations for advertising or publicity in printed, recorded or electronic media. I represent that I am of legal age and that I have the authority to give this consent, which will remain in effect until revoked by me in writing.


Rebuilding Together Kansas City (RTKC) prioritizes the health and safety of homeowners, contractors, volunteers, and staff. With the spread of the coronavirus or “COVID-19,” we all must remain vigilant in mitigating the outbreak and protecting one another.  To be safe and maintain operations, we have developed the wellness policies which will be implemented throughout the organization and at all of our work sites. RTKC has also developed COVID-19 Exposure Prevention Policies for Contractors, which are available upon request. RTKC will seek to follow all applicable and relevant government recommendations and may update the above policies at any time.
Also please note:

  • RTKC will suspend all home repair activities unless the homeowner has given express written consent for those activities to continue.
  • Homeowners authorizing home repairs are releasing RTKC, its contractors, its directors, and officers from any liability or claims that may arise from exposure to pathogens due to home repair activities.
  • Volunteers will notify RTKC immediately if they or any other resident at their home has tested positive or has been in contact with someone that tested positive for COVID-19.
  • RTKC staff and contractors will try to avoid physical contact with homeowners to the maximum extent possible.
  • Conversations with homeowners will be limited to electronic or phone conversations to the extent possible.
  • The homeowner has agreed to stay six feet away from any RTKC representatives (volunteers, staff or contractors) performing repairs on the home, in a separate room from in-progress maintenance when possible.
  • If possible, the homeowner agrees to wear a face mask when any RTKC representative(s) is on-site. If the homeowner does not have one RTKC will provide.
  • Volunteers agree not to use the home’s restroom facilities.
  • Volunteer agrees to use safe personal distancing during project duration when possible.
  • Volunteers agree to check their temperature is normal before coming to the project site.  Then the volunteer may begin work as long as the other requirements are met. If the temperature is elevated, the volunteer is asked to stay home.
  • The volunteer agrees to sanitize all tools before and after use when possible.
  • Volunteers agree to use their own tools when possible.

Please put your crew name here. If your crew does not have a name, please put the contact person you are working here.