Keep Lewisville Beautiful Time Card
Court Appointed Community Service

First Name:__________________________  Last Name: __________________________
Date: ____________________________________________________________________
Legal Guardian’s Name: ____________________________________________________
Legal Guardian contact numbers: (work/home) _________________  (Cell) ____________
Address: ______________________ City: ____________ Zip code: _________________
E-mail address:_____________________________________________________________

* Keep Lewisville Beautiful * 189 Elm Street Suite 106 * Lewisville Texas 75057 *
* 972-436-5100 * www.keeplewisvillebeautiful.org *

Keep Lewisville Beautiful Volunteer Contract

As a volunteer for Keep Lewisville Beautiful, you act as a representative of our organization to the community at large. For a better understanding of what you can expect as a volunteer and what is expected of you by our organization, we ask you to read and sign the following volunteer contract. If you are under the age of 18, your legal guardian needs to read and sign this contract too.

Keep Lewisville Beautiful will provide for you:

• All supplies needed to conduct community service trash pick up including a safety vest, gloves, trash bags, and a litter grabber.
• Up to 8 hours of court appointed community service every second saturday of the month, as per the KLB website calendar. Community service worker days and hours offered are subject to change without notice. Please contact KLB at 972-436-5100 for additional details or cancellations.
• An area to pick up trash that is age appropriate and supervised by a KLB representative.

Keep Lewisville Beautiful asks that you:

• Call two days prior to the scheduled work day to schedule the hours you want to work. We do not accept walk-ups.
• Follow all safety precautions while working in high traffic areas, always being responsible and alert to your surroundings.
--KLB is not responsible for accidents or injuries that occur while volunteering.
• Bring back unused supplies and the litter grabber in the condition it was given to you.
  --A fee of $7 will be charged for broken litter grabbers that were treated with negligence.
• Notify the organization's representative when you arrive to work, and before you have to leave the cleaning site for any reason. If you fail to do so, you may not get credit for the hours you worked.
• Bring all trash bags back to the KLB representative, to be disposed of properly. DO NOT leave trash bags at clean up location.
• Be courteous to other community service workers and KLB representatives. Wear appropriate cleaning attire, and stay within sight of the KLB representative.
• Always ensure your own transportation to and from the site. KLB does not offer transportation for community service volunteers.

• If you do not return, and do not check in with KLB, you will not get your hours.

*Always wear your safety vest while volunteering with KLB.
*Do not disturb animals or bugs while volunteering with KLB.
*While cleaning, please stay on sidewalks. Volunteers over the age of 16 may work on medians, but need to follow all traffic safety laws.
*DO NOT cross any street except at cross walks.

General Release Form:

RELEASE AND INDEMNIFICATION THE STATE OF TEXAS,COUNTY OF DENTON KNOW ALL MEN BY THESE PRESENTS:
                We have upon our own free will, requested to be volunteers for Keep Lewisville Beautiful.  I fully understand the dangers of working as a volunteer and accept that we may be subjected to such dangers and that there is an assumption of all such risks by entering into this release and indemnification and by participating as a volunteer.
                In consideration of being allowed to volunteer, voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the Keep Lewisville Beautiful, its officers, employees, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above.
With the intention of binding us, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions which we ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the Keep Lewisville Beautiful, and/or its officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of our participation as a volunteer during times of this indemnity agreement AND INCLUDING, WITHOUT LIMITATION, CLAIMS AND DAMAGES ARISING IN WHOLE OR IN PART FROM THE NEGLIGENCE OF Keep Lewisville Beautiful,  ITS EMPLOYEES, OFFICERS, SUCCESSORS, ASSIGNS, SPONSORS, AND VOLUNTEERS.
Furthermore, We agree to indemnify and hold harmless the Keep Lewisville Beautiful, and/or its officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages we may suffer as a result of claims, demands, costs, or judgments against the KLB and/or, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation as a volunteer. If KLB, and/or, its agents, officers, servants, employees, successors, assigns, sponsors, or volunteers in the enforcement of any part of this indemnity agreement, shall incur necessary expenses, or become obligated to pay attorney’s fees or court costs, We agree to reimburse KLB, and/or its agents, officers, servants, employees, successors, assigns, sponsors, or volunteers for such expenses, attorney’s fees, or court costs within thirty days after receiving written notice from KLB, and/or its agents, servants, employees, successors, officers, sponsors, assigns, or volunteers of the incurring of such expenses, costs, or obligations.
Additionally, We shall fully defend, protect, indemnify, and hold harmless KLB, and/or agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the KLB, and/or its agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by us, our agents, our successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from our participation as a volunteer, INCLUDING, BUT NOT LIMITED TO, CLAIMS AND DAMAGES ARISING IN WHOLE OR IN PART FROM THE NEGLIGENCE OF KLB AND/OR THE PARTIES TO THIS AGREEMENT.  IT IS UNDERSTOOD AND AGREED THAT THE INDEMNITY PROVIDED FOR IN THIS SECTION IS AN INDEMNITY EXTENDED BY THE VOLUNTEER TO INDEMNIFY AND PROTECT KLB AND/OR ITS AGENTS, OFFICERS, SERVANTS, OR EMPLOYEES FROM THE CONSEQUENCES OF THE NEGLIGENCE OF THE KLB AND/OR ITS AGENTS, OFFICERS, SERVANTS, OR EMPLOYEES, WHETHER THAT NEGLIGENCE IS THE SOLE OR CONTRIBUTING CAUSE OF THE RESULTANT INJURY, DEATH, AND/OR DAMAGE.
We further authorize the KLB employee or agent supervising this activity to secure medical care for us in the event of injury.  We promise to assume liability for payment, and hold harmless KLB, its officers, employees, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury.

By my signature I declare that I have read, understand, and agree with all parts of the volunteer contract and will strive to fulfill all parts therein. I will be honest about the hours I work and use my volunteer time efficiently and appropriately.

Volunteer Signature _____________________________   date: ________________________
*If underage, the signature of a legal guardian is needed to volunteer

As a legal guardian, I give KLB permission to allow _________________ to volunteer unsupervised picking up litter along designated areas suggested by KLB.

Guardian Signature: ______________________________ date: _________________________