Community Service Liability Form

I state that I am 18 years of age or older. I have been sentenced by the Court to the Community Service Program and I acknowledge that this sentence was an option provided to me so I might avoid a more restrictive sentence. I will perform the ordered hours of unpaid Community Service work as ordered and I will complete my required Community Service hours by the Due Date.

While performing Community Service, I will abide by the following conditions:

1. I will follow the Community Service work schedule provided to me, and will complete a minimum of six hours of Community Service work per week. My work schedule will not be changed without approval from the work site supervisor and/or my caseworker. Any revised schedule will allow me to put in a minimum of six hours each week.
2. I understand that attendance is mandatory. l understand that I must arrive at the work site at least five (5) minutes before I am scheduled to begin work. Attendance problems such as failure to report or repeated tardiness may result in termination from the work site and/or Community Service Program.
3. I may only be excused from work if I contact the work site supervisor in advance of the absence. If I will be absent two or more times, I will contact my caseworker with an explanation for the absences. I will make up the hours missed in order to complete the required hours by my assigned due date. Unexcused absences will likely result in termination from the Community Service Program and may result in a more restrictive sentence.
4. I must perform the assigned tasks to the best of my ability and my work must be satisfactory to the work site supervisor. I understand that I will be subject to the same work site rules and policies as other employees or volunteers at the work site. I will comply with the dress code imposed by the work site supervisor.
5. I must comply with any instructions given me by the work site supervisor and I must be cooperative with the work site supervisor and other workers. I will not engage in any assaulting, harassing, threatening, provoking or intimidating behavior. I must immediately report any problems with other workers to the work site supervisor. If the site supervisor cannot resolve the problem, I will contact my caseworker to discuss the issue.
6. I must arrive at the work site free from drugs or alcohol and I must report any prescription medications I take to my caseworker and the work site supervisor before starting work.
7. I may not bring a cell phone onto the work site and will ask permission of the work site supervisor before having any contact with friends or family members while at the work site.
8. If l am asked to perform a task that I reasonably feel might endanger my health or cause me harm, I will immediately inform the work site supervisor of my concern before performing the task. If I am unable to resolve the problem with the work site supervisor, I will immediately contact my caseworker to discuss the issue.
9. I must immediately report any injuries to myself or others to the work site supervisor.
10. If l should experience any difficulties or problems in performing the community service work for the assigned work site, I will contact the work site supervisor and attempt to resolve the problem. If resolution is not achieved with the site supervisor, I must immediately contact my caseworker to discuss and resolve the situation.
11. I agree that my participation in the Community Service Program shall be entirely at my own risk. I hereby indemnify and hold harmless Kent County, its officials, officers, employees, agents and assigns, and those of the work site, from and against all claims, judgments, losses, damages, demands, payments, recoveries, legal proceedings, orders, and decrees of every nature and description, including attorney fees, of me or any other person, arising out of or resulting from my participation in the Community Service Program.
12. I hereby expressly waive, for me, my heirs and assigns, the right to institute any action or suit at law or in equity against Kent County, its officials, officers, employees, agents or assigns, or those of the work site, or institute, prosecute, or in any way aid in the institution or prosecution of any claim, demand, action or cause of action for damages, costs, loss of services, expenses or compensation for or on account of any damage, loss or injury, either to person or property or both, resulting or to result, known or unknown, past, present or future, arising out of my participation in the Community Service Program.
13. I agree that the terms and conditions stated in Sections 11 and 12 above shall survive following my participation in the Community Service Program.
14. I understand that I am not considered an agent or employee of Kent County or the work site, and I am not entitled to any of the benefits that the County or the work site provides for its employees. l have no authority to obligate the County or the work site in any way, and shall not identify myself as an employee or agent of either.
15. I will notify my community service caseworker of any change in my address or phone number.
16. I authorize the release of information contained in my court records to the work site to which I am being referred.
17. If my caseworker or the work site supervisor find that I have violated any of the terms and conditions in this document, my participation in the Community Service Program may be terminated, which may result in a more restrictive sentence.

I have carefully read and reviewed the Acknowledgement of Participation, know and understand its contents, have received a copy, and have signed it as my free act and deed.

By typing your name below you agree to the rules of this agreement and your typed name is equivalent to your signature.