Night In A Car

VOLUNTEER LIABILITY FORM

I, the undersigned, understand that Bridge of Hope Centre County is not
responsible for any expense or liability incurred as a result of my participation in
Night In A Car, including medical expenses due to any sickness or injury incurred
as a result.

I understand the risks associated with my participation in Night In A Car. I assume
all related risks, both known and unknown to me, of my voluntary participation as
a volunteer, including travel to, from, and during any volunteer activity. I also
assume all the risks of participating in any or all activities and programs during
Night In A Car.

I do hereby consent for Bridge of Hope Centre County to use my image, likeness,
and/or voice in any photographs, videotape, or digital recordings of me for the
purpose of promoting Bridge of Hope Centre County, through print and electronic
publication, publicly or privately. I waive any rights, claims, or interest I may have
to control the use of my likeness in whatever media used.

I represent that I am at least 18 years of age, have read and understand the
foregoing statement, and am competent to execute this agreement. If under 18, a
parent or legal guardian must approve.

By checking the box on the Night In A Car Registration Form, you agree to these terms.