I/we understand that the applicant will be using facilities at his/her own risk and I/we hereby release, discharge, indemnify and hold harmless Special Olympics West Virginia (SOWV) from all liability for injury or accident to person or damage to the applicant’s property.

I/we understand that the applicant’s volunteer service can be modified or terminated with or without notice or cause, at any time, at the option of SOWV or at my/our option and that SOWV may, in its sole discretion, decline to accept the applicant for volunteering with or without cause.

I/we grant SOWV and Special Olympics, Inc. (SOI) permission to use the applicant’s likeness, voice, and words in or on television,

radio, and on SOWV and SOI’s Websites, or in any other form, format, or media, to promote Special Olympics and its mission and to raise funds for Special Olympics.

In the course of volunteering for SOWV I may be dealing with confidential information regarding athletes and volunteers’ contact information, date of birth, social security number, health, behavior and other personal information and I agree to keep said information in the strictest confidence.

In signing this application, I/we am verifying that I/we have read the foregoing information, and I/we agree to comply with the Volunteer Code of Conduct and all Special Olympics rules and regulations of the organization.

I/WE HAVE READ AND UNDERSTAND THIS DISCLOSURE.