Town of Craftsbury

I make this Statement and Agreement in order to provide, and to be authorized to provide, the following uncompensated service to the Town of Craftsbury as a volunteer helping during the coronavirus pandemic. In performing the specified volunteer service, I acknowledge that: * I am 18 years of age or older and know of no reason, medical or otherwise, which would prevent me from performing the tasks required; * I have acquainted myself with what is required to perform those tasks, and represent that I have the skill and ability to perform them; * I assume full responsibility for my own safety and the safety of others, and except where resulting from the negligence of the Town or its employees, I will hold the Town of Craftsbury harmless for any injury to me or damage to my property and for injury or damage resulting from my own negligence. * I am a volunteer worker and therefore am not covered by the town’s workers’ compensation policy; and * I will perform the volunteer service in compliance with the standards and specifications established, or approved, by the Town, and will honor the direction of the Town Officials to suspend or terminate service. By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.