I hereby authorize any and all law enforcement agencies to release all information regarding any conviction record I may have. I hereby release all individuals, corporations and agencies from all liability for any damage whatsoever that may ensue from furnishing it to Wellspring Charitable Gardens. I hereby agree also to be fingerprinted by WCG if so requested.*

I hereby authorize myself to volunteer for the Wellspring Charitable Gardens Program. *

I recognize and agree to assume the full risk of any injuries, damages or loss regardless of  severity which I may sustain as a result of participating in any and all activities connected with  or associated with such program(s). I agree to waive and relinquish all claims I may have as a  result of participating in the program against Wellspring Charitable Gardens, Keith and Cindi Martin and its officers agents, and employees.*

I do hereby fully release and discharge Wellspring Charitable Gardens, a program of United Charitable, Keith and Cindi Martin and its officers, agents, and employees from any and all claims from injuries, damages or loss which I or my minor child/ward may have or which may accrue to me arising out of, connected with, or in any way  associated with the activities of the transportation service, including but not limited to boarding,  exiting and transporting.*

In the event of any emergency, I authorize Wellspring Charitable  Gardens and Keith and Cindi Martin officials to secure from any licensed hospital; physician  and/or medical personnel any treatment deemed necessary for me immediate care and agree that  I will be responsible for payment of any medical services rendered.*

I have read and fully  understand the above information, warning of risk, assumption of risk and waive and release of  all claims and permission to secure treatment. If registering online or via fax, I understand my  online or facsimile signature shall substitute for and have the same legal effect as an original  signature. I have read and understand the above warnings of risk and waive all claims against Wellspring  Charitable Gardens and Keith and Cindi Martin. *

I do hereby grant permission for my picture /video to be used for publicity or in brochures  related to the programs of Wellspring Counseling Ministries or Wellspring Charitable Gardens.*

I certify that the statements made in this volunteer application are true and correct and have  been given voluntarily. I understand that this information may be disclosed to any party with  legal and proper interest and I release Wellspring Charitable Gardens and Keith and Cindi  Martin from any liability whatsoever for supplying such information. I understand that I will not be paid for my services as a volunteer.*