Name(Required)
MM slash DD slash YYYY
Address(Required)
Consent(Required)
I understand the work that I have volunteered to do and I hereby state that I am qualified and physically capable of accomplishing the work and activities for which I have volunteered, and that I will perform them as directed by a properly authorized supervisor. I also agree to comply with all DCR rules and regulations.

I hereby release the Commonwealth of Massachusetts and the Department of Conservation and Recreation (DCR), their employees, and agents from all claims, loss, damage, expenses and/or injuries, whether to person or to property, which may result from my actions while participating in volunteer activities or projects approved or sponsored by the Department. I further agree to indemnify, defend, and hold harmless the Commonwealth of Massachusetts and the DCR, their employees, and agents from liability for any damage or injuries resulting from my actions while participating in volunteer activities or projects approved or sponsored by the Department, that are found to be outside the scope of approved activities or projects.

I acknowledge that, by participating in such volunteer activities and projects, I have not received an appointment to state service, and I will not receive a salary or payment from the Commonwealth. As such, I understand that I am not entitled to Workers Compensation and that I cannot make any claims against the Department for any injury, loss, or damage to person (including bodily injury or death) or property suffered while involved in volunteer work or projects for the DCR and, further, that I will provide my own health insurance.

I recognize that MGL c. 21, §17G provides that, pursuant to the provisions, requirements, and limitations of MGL c. 258 and the guidelines adopted by DCR, I shall not be liable for injury or loss of property or personal injury or death caused by my negligent or wrongful act or omission while acting within the scope of my volunteer activities. However, I acknowledge that I will not be indemnified under MGL c. 258, §9 for intentional torts or for the violation of a person’s civil rights. I also acknowledge that in any litigation, the final determination of whether a person is considered an uncompensated employee is made the Attorney General’s Office.
MM slash DD slash YYYY
MM slash DD slash YYYY
Is this person a minor (under 18)?
For the purposes of DCR’s Volunteers in Parks Program, minors are defined as individuals under the age of 18. While minors may serve as volunteers for activities directly organized and supervised by DCR staff or by other organizations, written consent from a parent or guardian is required prior to a minor beginning his/her volunteer duties. Minors who arrive at a volunteer work site with adults who are not their parents, guardians or school officials serving en loco parentis will not be allowed to participate in volunteer activities without the written consent of the parent or guardian.
Name of Minor
Parent/Guardian Name
Accompanying Adult’s Name
(IF OTHER THAN PARENT/GUARDIAN, i.e. teacher, scout leader, club program leader)
(if applicable)
Minor’s Home Address

Below, please provide the requested information regarding the volunteer project/activities

Consent
I (parent or guardian) hereby release the Commonwealth of Massachusetts and the Department of Conservation and Recreation (DCR), their employees, and agents from all claims, loss, damage, expenses and/or injuries, whether to person or to property, which may result from actions while participating in volunteer activities. I further agree to indemnify, defend, and hold harmless the Commonwealth of Massachusetts and the DCR, their employees, and agents from liability for any damage or injuries resulting from the minor’s actions while participating in these volunteer activities. I also acknowledge that, by participating in such volunteer activities and projects, no salary or payment from the Commonwealth will be made to me (parent or guardian) or the minor.