2019-2020 Playground Improvement Project (PIP) Consent Form

Before volunteering for NYJL's Playground Improvement Project, please complete this form. You only need to complete this form once to volunteer. If you would like to participate in multiple park days, please select all corresponding dates in the form below. Thank you.

I understand that the work I perform today is volunteer activity, which I undertake willingly to help improve the park/playground/recreation center at St. Nicholas Park, New York, NY (“The Project”). In consideration for the privilege to work on The Project, which I hereby acknowledge, I hereby release and discharge the New York Junior League (“NYJL”), the New York City Department of Parks & Recreation (“Parks”) and the City of New York (“City”), and their present and former volunteers, officers, directors, employees, elected or appointed officials, insurers, attorneys and agents, and their respective heirs, successors and assigns (“Releasees”) from any and all liability arising now or in the future from or related to any actual, potential or threatened claims or causes of action or any other liability of any kind, including, but not limited to, that arising from, directly or indirectly or related to negligence, personal injury, sickness, property damage, theft and expenses, as a result of any action taken or not taken, directly or indirectly, by one or more of the Releasees, acting alone or in concert, in connection with any work or services performed by me in connection with The Project.

I hereby consent to and permit emergency treatment in the event of injury or illness while participating in The Project.

I hereby give permission to the NYJL to reproduce images of me/ my child/ my children. I understand that these images will not be used for commercial purposes, but may appear in NYJL publications or be used to promote one or more of the NYJL’s charitable projects. By clicking 'I accept' below I certify that I have read and agree to the terms above. 


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