NDA-HEALTH NOW® Volunteer Registration Form and Release

This Release and Waiver of Liability (the “Release”) executed on the day this form is electronically submitted on behalf of the above-named volunteer, (the “Volunteer”) in favor of the National Dental Association (the “NDA”), each of its directors, officers, employees, and agents. The Volunteer desires to work as a volunteer for the NDA and engage in the activities related to being a volunteer consisting of the NDA-HEALTH NOW® Annual Convention Community Outreach Program, which may include physical labor, exposure to hazardous conditions or other circumstances that may result in personal injury, and I do hereby give my consent to participation in all activities of the NDA. The Volunteer understands that the scope of the Volunteer’s relationship with the NDA is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; and that NDA will not provide any benefits traditionally associated with employment to Volunteer. The Volunteer desires that the Volunteer engage in activities related to serving or participating in the NDA’s activities as a participant or volunteer. The Volunteer is responsible for the Volunteer’s own insurance coverage in the event of personal injury or illness as a result of participation in the volunteer activities.

1. Waiver and Release: I release and forever discharge and hold harmless the NDA 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 the activities as a Volunteer with the NDA, including claims arising out of negligence. I understand and acknowledge that this Release discharges NDA from any liability or claim that I may have against NDA with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services the Volunteer provides to NDA or occurring while Volunteer is providing volunteer services.
2. Assumption of Risk: I understand that the volunteer activities may include activities that are inherently dangerous to me, as set forth above. I hereby expressly assume the risk of injury or harm to me from these activities and Release NDA from all liability for injury, illness, death, or property damage resulting from the services I provide as a volunteer or occurring while I am participating in events.
3. Insurance: I affirm that I am covered by primary medical insurance and understand that I am responsible for my medical bills if injury occurs. Further, I understand that NDA does not assume any responsibility for or obligation to provide the Volunteer with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of the Volunteer’s injury, illness, death or damage to his or her property. I expressly waive any such claim for compensation or liability on the part of NDA beyond what may be offered freely by NDA in the event of such injury or medical expenses incurred by the Volunteer.
4. Medical Treatment: I hereby release and forever discharge NDA from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with NDA. I give my consent for the NDA to provide, administer, or obtain medical treatment for me. 5. Photographic Release: I grant and convey to NDA all right, title, and interests in any and all photographs, images, video or audio recordings of the Volunteer or his or her likeness or voice made by NDA in connection with the Volunteer participating in NDA events, including but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
5. Other: I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Louisiana and that this Release shall be governed by and interpreted in accordance with the laws of the State of Nevada. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected. By selecting "I understand and agree", below, I, the above named Volunteer, express my understanding and intent to enter into this Release and Waiver of Liability knowingly and voluntarily.