FOIP Statement/Acknowledgement and Waiver


The personal information on this form is collected under the authority of section 33(c) of the Freedom of Information and
Protection of Privacy Act. It will be used by the City of Edmonton to communicate with volunteers about the Capital City Clean Up Litter Kit Program; to send out volunteer recognition and prizes; to maintain accurate records of volunteer involvement for insurance purposes; and to provide information to volunteers on future Capital City Clean Up volunteer opportunities. If you have any questions about the collection, use or disclosure of your personal information, please contact the Volunteer Programs Advisor P.O. Box 2359 Edmonton, AB, T5J 2R7, 780-496-8047.
Acknowledgement and Waiver

1. I acknowledge and accept that:
(a) There are risks associated with picking up, transporting, collecting and disposing of litter, and with using the litter
kits and equipment provided by the City of Edmonton (the “City”) through its Capital City Clean Up Litter Kit Program
(the “Program”). I am responsible for performing all of these activities safely and properly.
(b) I have read and agree to abide by the Safety Guidelines set out below. I will also abide by the City’s volunteer
policies and any Program guidelines or procedures.
(c) I am responsible for keeping a record of my volunteer hours and the number of garbage bags collected and disposed.
(d) The City may provide insurance coverage in the event of personal injury to myself or my team members, and in the event of personal injury or property damage to a third party. I may also be eligible for benefits under the Workers’ Compensation Act (Alberta).
2. I agree to waive any and all claims that I have, or may have in the future, or that my child(ren) has/have, or may have
in the future, against the City, its employees, volunteers, agents or contractors as a result of any injury, illness, death, loss, expense or damage where that claim arises out of, or is in any way connected, with the City’s provision of the Program; our
application to, or participation in, the Program; and our handling, transport, collection or disposal of any waste materials. This includes any claims of negligence, breach of contract or breach of any statutory or other duty of care. This waiver shall be effective and binding upon our heirs, next of kin, executors, administrators and assigns, in the event that any of us should die.
3. I have read this agreement prior to signing it and I understand its effect. I am aware that by signing this agreement I
am waiving certain legal rights that I or my child(ren), and our heirs, next of kin, executors, administrators and assigns
may otherwise have had against the City.


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