SOP_NUMBER: 502.01-att-9
TITLE: Georgia Department of Corrections Recreation Program Visiting Volunteer Waiver of Liability
DIVISION: Inmate Services
TOPIC_AREA: Recreation Services
EFFECTIVE_DATE: 2022-04-07
WORD_COUNT: 230
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/714169
URL: https://gps.press/sop-data/502.01-att-9/

SUMMARY:
This is a waiver of liability form that volunteers must complete and sign before working with inmates in GDC recreation programs. The form collects volunteer contact information, requires volunteers to acknowledge the risks of working with offenders, and releases the State of Georgia and GDC from liability for injuries or incidents. It also authorizes background checks and requires disclosure of any criminal convictions or parole/probation status.

KEY_TOPICS: volunteer waiver, liability release, recreation program volunteer, background check, criminal history disclosure, parole probation status, volunteer agreement, inmate interaction, risk acknowledgment

ATTACHMENTS:
  1. Georgia Department of Corrections Recreation Equipment Master Inventory Sheet
     URL: https://gps.press/sop-data/502.01-att-1/
  2. Recreation Aide Job Description & Responsibilities
     URL: https://gps.press/sop-data/502.01-att-2/
  3. Attachment 3 - Monthly Recreation Report
     URL: https://gps.press/sop-data/502.01-att-3/
  4. Recreation Aide Work Sign-In Sheet
     URL: https://gps.press/sop-data/502.01-att-4/
  5. Recreation Services - Orientation Presentation Template
     URL: https://gps.press/sop-data/502.01-att-5/
  6. Leisure Activity Survey
     URL: https://gps.press/sop-data/502.01-att-6/
  7. Weekly Safety and Sanitation Inspection Form
     URL: https://gps.press/sop-data/502.01-att-7/
  8. Recreation Maintenance Work Request
     URL: https://gps.press/sop-data/502.01-att-8/
  9. Georgia Department of Corrections Recreation Program Visiting Volunteer Waiver of Liability
     URL: https://gps.press/sop-data/502.01-att-9/

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FULL TEXT:
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SOP 502.01
Attachment 9

4/7//22

# **Georgia Department of Corrections** **Recreation Program** **Visiting Volunteer Waiver of Liability**


Name: ________________________________________________________________Date of Birth: ______________________


Address (Street): _________________________________________________________________________________________


City, State, Zip Code: _____________________________________________________________________________________


Telephone (Home: ________________________________________(Work): __________________________________________


Name of Group and Activity in Institution/Center: _______________________________________________________________


Date: Time In:


In consideration of having been accepted as a volunteer for the above listed activity, and with the knowledge that I will be working,
directly and indirectly, with offenders, I recognize fully that my presence may involve some element of risk.


I, the undersigned, do hereby waive and release any and all rights or claims of any kind or nature which may exist or accrue in the
future against the State of Georgia, the Georgia Department of Corrections, (Name of Institution/Center), its personnel, employees,
staff or agents because of, as a result of, or in connection with the duties, responsibilities and work which I will undertake.


In making this application, I hereby give the Georgia Department of Corrections authority to make inquires with police records as
may be deemed necessary to ascertain my suitability as a volunteer.


Signature of Volunteer Date Signed


Have you ever been convicted of a criminal offense? ___________ If yes, explain briefly: _______________________________


Are you currently on parole or probation? ______________ If yes, explain briefly: ____________________________________

_______________________________________________________________________________________________________


_______________________________________________________________________________________________________


_______________________________________________________________________________________________________


Retention Schedule: Upon completion, this form will be maintained at the participating facility for a period of six (6) months after
the visitation of the volunteer, then destroyed.