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Liability Release for 2022 Trail Mix Volunteers

 

I acknowledge that this release of liability form will be used by Trail Mix, Inc. for volunteer activities in which I chose to participate, and that it will govern my actions and responsibilities at said volunteer activity.

I waive, release, and discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or person released, for my contracting COVID-19, death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from Trail Mix, Inc. volunteer activities. The released entities or persons include: Trail Mix, Inc. and its staff, directors, representatives, vendors, sponsors, other volunteers, and owners of properties where volunteering is taking place.

I hereby assume all of the risks of volunteering, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, risks associated with contracting COVID-19 from other participants or staff on the project, or because of their possible liability without fault.

I indemnify, hold harmless, and agree not to sue the entities or persons referenced above from any and all liabilities or claims made as a result of volunteering with Trail Mix, Inc., whether caused by the negligence of release or otherwise. I acknowledge that this volunteering may involve interaction with other volunteers and the public who may unknowingly have COVID-19 and may carry with it the potential for death, and serious injury.

I certify that I:

• Am physically fit and have not been advised to not participate by a qualified medical professional.

• Have no health-related reasons or problems which preclude my participation in volunteering.

• Have read the CDC guidelines regarding COVID-19 and underlying conditions that would put me at high risk of severe illness and determined my volunteering will not unduly jeopardize my safety.

• Will complete a COVID-19 self-evaluation before attending any and every volunteer activity.

• Acknowledge and am willing to abide by Trail Mix, Inc policies, procedures, and protocols, and COVID-19 Risk Assessment.

I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I certify that I have read and fully understand this document and its content. I am aware of risks and concerns related to COVID-19 and that this is a release of liability as well as a contract, and I sign it of my own free will.

I grant Trail Mix, Inc., its representatives, and employees the right to take photographs and/or video of me in connection with the event(s) in which I am participating. I authorize Trail Mix, Inc., to copyright, use, and publish the same in print and/or electronically. I agree that Trail Mix, Inc. may use such photographs and/or video of me with or without my name and for any lawful purpose, including publicity, illustration, advertising, social media, and Web content.

 

 

 

 

 

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Gender Pronouns

Pronouns
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Gender Pronouns

Pronouns
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Gender Pronouns

Pronouns
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Gender Pronouns

Pronouns
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Gender Pronouns

Pronouns
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Gender Pronouns

Pronouns
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Gender Pronouns

Pronouns
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Gender Pronouns

Pronouns
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Gender Pronouns

Pronouns
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Gender Pronouns

Pronouns
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information and newsletters by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Volunteer Activity
What type of volunteer event are you participating in?
Open call volunteer event - anyone can come!
Trail Stewards
Volunteer Trail Maintenance Team
Other
If applicable, what group do you belong to?
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Gender Pronouns

Pronouns
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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