Work Crew Liability Form Court Services Work Crew - Release of Liability ACKNOWLEDGEMENT OF PARTICIPATION, RELEASE OF LIABILITY AND COVENANT NOT TO SUE I state that I am 17 years of age or older. I have been sentenced by the Court to the Kent County Work Crew and I acknowledge that this sentence was an option provided to me, so I might avoid incarceration. I will perform the ordered hours of Work Crew service, for which I will not be paid, and I will complete my Work Crew service hours by due date.Ordered Hours Work Crew*Work Crew Hours Due Date Month Day Year Work Crew Start Date* Month Day Year Case Worker*Angela DuursmaJonathan LandonBrenda McWatersJose RegalRyan Brundage While on the Work Crew, I will abide by the following conditions: I will follow the work schedule provided to me and will complete a minimum of 12 hours of work per week. I must meet the Work Crew Supervisor at 703 Ball Avenue NE, Grand Rapids, MI 49503 (Kent County Jail-Visitation Parking Lot - go to red Work Crew van) at least five (5) minutes before I am scheduled to begin work. I understand attendance is mandatory. I may only be excused from Work Crew if I present written documentation of an emergency situation involving medical treatment, a court appearance, or death in the family. I must call my Work Crew Caseworker before 4:00 PM on the day of the absence and present the written documentation to my Work Crew Supervisor on my next scheduled work date. I understand that unexcused absences will likely result in my termination from the Work Crew Program. I must stay with the other members of the Work Crew at all times and I must perform the assigned tasks to the best of my ability. I understand that my work must be satisfactory to the Work Crew Supervisor. I must comply with any instructions given me by the Work Crew Supervisor. I may not engage in any assaultive, harassing, threatening, provoking or intimidating behavior and I must immediately report any problems with other members of the Work Crew to the Work Crew Supervisor. I must immediately report any injuries, to myself or others, to the Work Crew Supervisor. I must arrive for Work Crew free from drugs or alcohol and I must report any prescription medications I am taking to my Work Crew Supervisor before starting work. I acknowledge that the work I will be doing may consist of outdoor manual labor and clean-up projects. I will wear long pants and a shirt with sleeves to work and will arrive at work dressed appropriately for the weather. Open toe shoes, sandals, and flip flops are NOT permitted. If I need safety equipment to perform my tasks, it will be provided by my Work Crew Supervisor. I may not have a cell phone or any electronic devices while on Work Crew. If I am caught on my cell phone, or with any electronic devices I will be sent home for the day with no credit. I may not smoke during working hours or in any County vehicle. I may not possess any weapons on my person. I know of no reason, medical or otherwise, that would prevent me from participating in the Work Crew Program. I agree that my participation in the Work Crew 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 Work Crew Program. 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 Work Crew Program. I agree that the terms and conditions stated in Sections 12 and 13 above shall survive following my participation in the Work Crew Program. I understand that I am not considered an agent or employee of Kent County or any other entity for which work is performed, and I am not entitled to any of the benefits that the County or any other entity provides for its employees. I have no authority to obligate the County or any other entity in any way and shall not identify myself as an employee or agent of either. If, in the sole discretion of my Work Crew Supervisor or Work Crew Caseworker, it is found that I have violated any of the terms and conditions contained in this document, my participation in the Work Crew Program shall be terminated, which may result in further action by the court and possible incarceration. I have carefully read and reviewed the Acknowledgement of Participation, know and understand its contents, have received a copy, and signed it as my free act and deed. **Note: To check for cancellations please call (616) 632-5287** By typing your name below you agree to the rules of this agreement and your typed name is equivalent to your signature. Name* Email Work Crew ScheduleMonday 8am-12pm 12pm-4pm 4:30pm-8:30pm Tuesday 8am-12pm 12pm-4pm 4:30pm-8:30pm Wednesday 8am-12pm 12pm-4pm 4:30pm-8:30pm Thursday 8am-12pm 12pm-4pm 4:30pm-8:30pm Friday 8am-12pm 12pm-4pm 4:30pm-8:30pm Saturday 8am-12pm CAPTCHA