Volunteer Service Agreement - WAIVER OF LIABILITY     
      
            By answering YES to the registration question associated with this agreement, the Volunteer acknowledges his or her appreciation of the risks of participating in the Mom-n-PA events to provide free dental services and on behalf of themselves and their estate hereby affirmatively waives any right of recovery and releases MOM-n-PA, their officers, officials, employees and agents, from liability related to the Undersigned, arising from any and all injury to persons and damage to property, and further agrees and undertakes to indemnify, hold harmless and defend MOM-n-PA from and against any and all claims, damages, actions, liability and expenses including attorney’s fees and other professional fees in connection with bodily injury including death, personal injury including needlestick injuries and/or damage to property arising from or out of the Volunteer’s activities and participation in volunteer services at the above MOM-n-PA 2013 event.  This waiver includes any gross negligence by MOM-n-PA.

            The Volunteer further acknowledges and agrees that MOM-n-PA does not assume any responsibility whatsoever for any property of the Volunteer and the Volunteer shall not hold MOM-n-PA liable for any loss or damage to same.

            The Volunteer also grants to MOM-n-PA and its agents the right to use your picture, voice, and other reproductions of your physical likeness in connection with advertising or publicizing MOM-n-PA services and its activities in all forms of media in perpetuity.