Foodshed Alliance · Foodshed Alliance Volunteer Waiver

Contact Information

Please provide the following information.

Name

*

First Name

Last Name

Email

*

Verify Email

*

Phone

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

EMERGENCY CONTACT NAME

*

For your safety, please provide your emergency contact's name.

EMERGENCY CONTACT PHONE

*

For your safety, please provide your emergency contact's phone number.

Release of Liability and Waiver of Damages

In the event that I, or the minor named above, suffers any illness or accident requiring emergency hospitalization, medication, or surgery while participating in a volunteer project, on the recommendation of the doctor and in the event of the inability to notify the emergency contact person listed below, I hereby give my permission for any medical treatment which may be deemed necessary and reasonable under the circumstances.

In order to participate as a volunteer, I understand and agree to enter this release of liability and wavier of damages. The Undersigned hereby agrees that the Foodshed Alliance, and the farmers, land owners, or operators participating in the program, their representatives, officers, employees, agents, volunteers, and governing board members (Indemnities) shall not be liable for any injury (including death) to me from participating in the volunteer event, regardless of how such injury or damage be caused, sustained or alleged to have been sustained by the participant or others as a result of any condition (including defects in equipment or land, negligent supervision, or any other cause) or occurrence whatsoever related in any way to the volunteer event, and travel to or from said event. The Undersigned hereby releases and waives all claims and causes of action of any nature whatsoever against the indemnities from any claim, cause of action, judgment, or liability for such injury or damage, and further accepts any risk associated with participating in the volunteer event and waives any claim for damages resulting from injury or damage. I fully understand and comprehend that reasonable care will be exercised by the volunteer coordinator for the volunteer events to protect the safety of those involved.

Please initial here that you have read, understood, and agree to the above.

*

By initialing here, you also acknowledge that the information provided above is correct.

Your Name if signing for a minor

Photo Release

*

I also grant permission for my picture, or that of the minor(s) named below, to be taken and/or voice recorded and grant permission to use my photos and voice without restriction for the purposes of this project with or without my name, be it in print, projection, internet web site, video or social media for the use of publicity and advertising of the program.

Yes, you can take/use my photo.

No, please do not take or use my photo.

Email Updates

*

We send an email newsletter weekly, and the occasional call for volunteers and event announcements.

Yes, I'd like to receive email updates from the Foodshed Alliance.

No, please do not send me emails.

Name(s) of Minor(s)

For safety reasons, please provide the names of any minors attending volunteering events.

Group Name

*

If you are volunteering as a part of a group, please state the group's name here. (for example: Catholic Work Camp, or Applegate Corp) *If you are not part of a group, please write "N/A"*