NOTE: Ecosource Mississauga does not accept paper waivers, please submit electronically.

Ecosource Participant/Volunteer Waiver Form

Thank you for your interest in participating/volunteering with Ecosource! All participants/volunteers MUST have a signed waiver in order to participate in program activities. If you are under 18 years old, please complete this form with the help of a parent or guardian.

Contact Information

Additional Information

Does the participant/volunteer have:

Any severe allergies to food or other substances?

Informed Consent & Assumption of the Risk and Waiver of Liability

Please read the following carefully.

1. I have read and understood the information provided in this form about participating/volunteering for Ecosource. I hereby willingly consent to release Ecosource from all liabilities and waive all claims and demands arising from personal injuries I (or the participant/volunteer if under 18 years of age) may incur while participating/volunteering with Ecosource.
2. I understand that photographs and/or videos may be taken of myself (or the participant/volunteer if under 18 years of age) and may be used in the promotion of Ecosource. They may be published or used for any application in newspapers, magazines, film, television commercials, posters, slide presentations or otherwise displayed to the public or used for educational, fundraising, information or training purposes.
3. I understand that I will not receive any compensation for photographs or videos taken of myself (or the participant/volunteer if under 18 years of age) during Ecosource activities.
4. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I (or the participant/volunteer if under 18 years of age) may be exposed to or infected by COVID-19 by participating in Ecosource’s programs and that such exposure or infection may result in personal injury, illness, permanent disability, and death.
5. I voluntarily agree to assume all of the COVID-19 risks and accept full responsibility for any injury to me (or the participant/volunteer if under 18 years of age), while participating in Ecosource programs including any claims, losses, personal injury, disability, death and any other health related COVID-19 risks. I agree to hold harmless, indemnify, defend and waive any liability against Ecosource from any direct or indirect damages, suits or claims including legal expenses sustained as a result of or in relation to any matters under this agreement or in consequence of any breach of any representation or obligation made herein.
   
6. I understand and agree that Ecosource may share my personal information (including my name and contact information) with other agencies, including Peel Public Health, for the express purpose to manage the spread of COVID-19. If it is necessary to disclose my personal information, I understand that I will be contacted in advance and provided the reason for disclosure, unless this is prohibited by law or regulation as determined by a public body.
7. Ecosource is committed to fostering a safe, inclusive, and welcoming environment through our programming. All participants/volunteers are expected to uphold our value of inclusivity and not engage in behaviours or actions that are discriminatory or may be perceived as discriminatory by others. Violation of this policy may result in discipline including removal from the program at the discretion of Ecosource.

Volunteers/Participants under the age of 18

I am the parent or legal guardian of the child(ren) named below. I have read the Informed Consent & Assumption of the Risk and Waiver of Liability and I understand the legal consequences of signing this document. I assume all risks of my child(ren)’s participation in Ecosource’s programs and agree to waive any claims relating to their participation against Ecosource and their respective employees.

Thu Apr 25, 2024