In connection with my application for volunteering with Tu Nidito, I understand that a consumer report may be requested to verify my identity through my social security number. I also understand that you will be requesting information concerning my motor vehicle operation history and criminal history from various states of residency, private and insurance sources along with other public records available.

I acknowledge that Tu Nidito Children and Family Services is an agency whose purpose is to provide support to children and their families as they deal with serious illnesses and/or death. I hereby agree to follow the strictest of ethics when trusted with confidential information. This confidential information includes but is not limited to: the identities of Tu Nidito participants, files pertaining to families, information concerning the organization, volunteers and/or staff, and information received from interviews, one on one visits, support groups, or special events.

WAIVER AND RELEASE: I hereby release and forever discharge and hold harmless Tu Nidito Children and Family Services, its officers, directors, agents, volunteers and employees, and their respective successors and assigns (collectively, "Tu Nidito") from any and all liability, claims, demands and causes of action, of whatever kind or nature, either in law or equity, which may hereafter arise from my volunteer work and participation with Tu Nidito, including transportation to and from Tu Nidito.

I understand and acknowledge that this Release discharges Tu Nidito from any liability or claim that I may have against Tu Nidito with respect to any bodily or other injury, illness, death, or property damage that may result from my volunteer work and participation with Tu Nidito, including transportation to and from Tu Nidito. I also understand that Tu Nidito does not assume any responsibility or obligation to provide financial or other assistance, including, but not limited to, medical, health, or disability insurance, in the event of injury, illness, death, or property damage.

ASSUMPTION OF RISKS. I understand that occasionally accidents occur and that participants may sustain serious personal injury as a consequence thereof. Knowing the risks, nevertheless, I am volunteering for Tu Nidito and freely accept and fully assume all such risks and dangers and the possibility of personal injury, death or property damage and loss resulting from any cause whatsoever, whether such risks are caused by the negligence of Tu Nidito or otherwise. Further, I acknowledge that Tu Nidito accepts no responsibility for the loss, damage or theft of personal property.

OTHER. The laws of the state of Arizona will govern this Release. This Release is intended to be as broad and inclusive as permitted by Arizona law. If any portion is held invalid, the balance will continue in full legal force and effect. This Release is binding on and inures to the benefit of the parties and their respective successors and assigns. I have read this agreement, fully understand its terms, have signed it freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

I have completed and reviewed this entire form and attest that the information provided is true. I also grant permission for Tu Nidito to obtain information from my references and/or other volunteer organizations with which I have worked that may be pertinent to my application.