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September 20th
Wintler Wednesday Beach Clean-Up
Please fill out this form if you plan to drive to the event.
Please only 1 registration per vehicle. Additional adult guests should be listed as 'Additional Guests' on this form and should fill out a separate registration/waiver
here
.
If you would like to park elsewhere and walk, ride your bike, get dropped off, or are an adult passenger in a vehicle please
register here.
What:
Volunteer Beach Clean-Up at Wintler Park
When:
Wednesday, September 20th 9:30am - 11:30am
Where:
Wintler Park, 6400 SE Beach Dr., Vancouver, WA 98661
What to bring:
Please dress for the weather. Bring your own snacks and water.
Before attendance at a volunteer event, please complete the form below and agree to the release of liability and waiver.
All ages and abilities welcome, but those younger than 13 must be accompanied by an adult.
Litter picker uppers and gloves will be provided.
Prior registration is required.
Contact
micayla@thewatershedalliance.org
if you have additional questions.
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Are you 18 years old or older?
*
Yes
No
Emergency Contact Name
*
Emergency Contact Phone Number
*
Are you a minor, or are any minors volunteering with you?
*
Minors are considered anyone under the age of 18. Minors younger than 13 must be accompanied by an adult. All minors must have parent/guardian fill out the consent/waiver.
Yes
No
Names of minors
*
Name of parent or guardian and phone number
*
If you are at least 14 and under 18 years of age, please provide the name and phone number of a guardian and have that person review and agree to the waiver below.
FOR THE PARENT/GUARDIAN
*
BY AGREEING BELOW, I CERTIFY THAT I HAVE READ THE FOREGOING TERMS, UNDERSTAND THEM FULLY, AND AGREE TO THE SAME. Volunteers under age 18 must have a parent or guardian sign a consent form before performing work, acknowledging that they are aware their dependent is volunteering, and that they have read this form and consent to the agreement, including the following: I understand and agree that this Release and Hold Harmless Agreement governs any action resulting from property loss, damage, bodily injury, or death that may result from my child’s participation in these volunteer activities, except as may arise solely from the gross negligence of the Watershed Alliance or the City of Vancouver. I understand that, by signing this Waiver, I am not waiving any rights or claims my child may have for his/her own damage or injury resulting from his/her participation in this activity.
Yes, by checking this box I certify that I have read the foregoing Waiver, understand it fully, and agree to the same.
Hold Harmless/Consent Waiver
*
By checking the box below, I am acknowledging that I have read this waiver, understand it and freely and voluntarily agree to its terms and conditions. I have volunteered to assist The Watershed Alliance of SW Washington (WA) and City of Vancouver (The City) in the above-described project. (1) I understand that my activities as a volunteer may entail a risk of physical injury and I may be exposed to conditions involving risk of harm. I understand and voluntarily assume all such risks of my own free will. (2) I hereby release The WA and The City, its officers, directors, employees and agents, co-sponsoring organizations or individuals from any and all claims, losses, liabilities or damages arising from or in any way related to their acts or omissions or my service as a volunteer. I do so for myself, my estates and personal representatives thereof, my heirs and assigns. (3) In case of emergency, accident or illness, I give my permission to be treated by a professional medical person and admitted to a hospital, if necessary. I agree to be the party responsible for all medical expenses which are incurred on my behalf.
Yes, by checking this box all listed adults certify that they have read the foregoing Waiver, understand it fully, and agree to the same.
COVID-19 Agreements
*
1. Notify the event leader immediately if abnormal symptoms appear before, during, or after the event
Yes, I agree.
Photo Permissions
*
I agree that photographs or videos taken of me may be used by the Watershed Alliance in any material or publications, printed or electronic.
I do not want photos or videos taken of me to be used by the Watershed Alliance in any materials or publications. If you do not want your photos used please let us know when you check in at event.
Add an additional adult?
Each adult should register separately on the non-driving registration form.
Yes
Additional Adults
First Name
Last Name
Add a second additional adult?
Yes
Additional Adults 2
First Name
Last Name
Add a third additional adult?
Yes
Additional Adults 3
First Name
Last Name
Did you hear about this event from the Watershed Alliance?
*
Our social media, newsletter, tabling, etc.
Yes
No
How did you hear about this event?
*
Check all that apply.
Social Media (Facebook/Instagram)
Newsletter
Tabling event
Word of Mouth
Other (please write in box)
If other, please describe here.
Example: other organizations, other newsletters/calendars, workplace, library, etc.
How did you hear about the event?
*
Please name the organization, location, or person who let you know. It's okay to write "friend" or "family."
Optional: Which of these categories do you identify as?
Caucasian/White
Latina/o/x
Hispanic
African American/Black
Asian
Pacific Islander
Native American, American Indian, Native Hawaiian, or Alaska Native
Asian Indian
Middle Eastern
Other (please describe below)
If other, please describe here:
Optional: Please select your age range.
13-17
18-29
30-44
45-64
65 & Older
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