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This release and waiver of liability releases Gracepointe, organized and existing under the laws of the State of and each of its directors, officers, employees, and agents. The volunteer desires to provide volunteer services for Gracepointe, and engage in activities related to serving as a volunteer. Volunteer understands that the scope of the volunteer’s relationship with Gracepointe is limited to a volunteer position, and that no compensation is expected in return for services provided by Volunteer; that Gracepointe will not provide any benefits traditionally associated with employment to volunteer; and that volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of volunteer’s services to Gracepointe. 1. Waiver and Release: I, the volunteer, release and forever discharge and hold harmless Gracepointe and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Gracepointe. I understand and acknowledge that this release discharges Gracepointe from any liability or claim that I may have against them with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Gracepointe, or occurring while I am providing volunteer services. 2. Insurance: Further I understand that Gracepointe does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I expressly waive any such claim for compensation or liability on the part of Gracepointe beyond what may be offered freely by Gracepointe in the event of such injury or medical expense incurred by me. 3. Medical Treatment: I hereby release and forever discharge Gracepointe from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Gracepointe. 4. Photographic/Video Release: I grant and convey to Gracepointe all rights, title, and interests in any and all photographs, videos, or audio recording of me or my likeness or voice made by Gracepointe in connection with my providing volunteer services to Gracepointe.

I have read, understand and agree to the terms set forth in this release form.