September 26, 2016

Cleanup Release Form

PHOTO RELEASE AND HOLD HARMLESS AGREEMENT

 

ADULT Clean-up Project VOLUNTEER

 

Undersigned volunteer acknowledges that he or she will be acting as a Wounded Nature – Working Veterans’ Volunteer for a coastal cleanup.  You are volunteering to perform various tasks such as clean up and/or removal of litter and debris from designated beach/park/marsh/island/canal tidal coastal area.

 

Waiver and Liability Release: In signing this for myself or the named participant, I understand that participation in the Wounded Nature – Working Veterans’  Cleanup, as in any cleanup event, may involve hazardous activity. I agree to accept and assume all risk and danger incidental to the Cleanup occurring prior to, during, or subsequent to the actual cleanup including but not limited to the risk of physical injury, mental injury, emotional distress, trauma, death, contact with other participants, equipment failure, inadequate safety equipment, the effect of weather including extreme temperature or conditions, traffic, contact with motor vehicles of all types and descriptions, contact with trash of unknown origin, or conditions of the shoreline. I waive any and all specific notice of the existence of the risks and hazards. In consideration of being allowed to participate, I, for myself and anyone acting on my behalf, agree to absolve Wounded Nature – Working Veterans, board, staff, corporate event sponsors, participants, donor,  site coordinators, park districts, beach authorities and their representatives, singly or collectively, of all blame for any injury, misadventure, harm, loss, or inconvenience suffered as a result of taking part in this Cleanup or in any of the activities associated with it.

 

Photo Release: I hereby grant permission to Wounded Nature – Working Veterans and all event associated parties to use my name and photographs or any other record of my participation in this event for any purpose. *If I am signing as a parent or adult supervising a minor, I represent that I am acting in that capacity and agree to save and hold harmless each of the parties above from all liability or damage which may be imposed upon said parties because of any lack of such capacity to so act on behalf of the minor.

 

Print Name                                               Email Address*

*Providing your email address is optional.  It will be used by Wounded Nature – Working Veterans and their event sponsors to keep you updated on upcoming events and items that may be of interest to you.

 

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