Millvale Earth Day Community Clean Up Volunteer Waiver

Millvale Earth Day Community Clean Up Volunteer Waiver

Thanks for helping us keep our community clean and litter free! All participants will be required to fill out the following Volunteer Waiver prior to the Saturday, April 18th event. Get a head start on the day by filling out this digital version now! Thanks to PennDot, the Millvale Community Development Corporation will be providing gloves, vests and garbage bags to all participants. Stop by 216 North Avenue, Millvale 15209 between 8:30am and 9:00am to pick up your supplies. Please dress appropriately for the weather and your own safety that day by wearing comfortable, closed toed shoes, long sleeves and pants, and bring any other gear/supplies you and your group may need. Clean-up will take place between 9:00am and 12:00pm. Please email millvalecdc@gmail.com if you have any questions. Thanks!
Name

First NameLast Name
Organization (if applicable)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I already spoke to someone at MCDC and was assigned a street/location for the clean up (no worries if not, we will contact you via email or assign you an area at supply pick up).
*Parental Consent required if a child under 18 is participating*
First and last name(s) of your child/children has my permission to participate in this event. If I cannot be reached in an emergency, the following person is authorized to act on my behalf: First Name Last Name Relationship to child Phone Number
MCDC may take my photograph and use my image to promote the mission and vision of MCDC with no compensation due me.
Please read the following statement and sign below using your finger on a smartphone or the mouse on a computer:

In consideration of the opportunity to engage in volunteer work through the Millvale Community Development Corporation (MCDC), I the undersigned, my heirs and assigns, hereby waive all claims for injuries, damages or losses to my person or property which may be caused directly or indirectly, by any act, omission or negligence arising from or related to the activities of the MCDC. I, the undersigned, understand that by participating in this volunteer activity I will be exposed to the risks of accident and injury and that I will follow MCDC’s safety requirements and instruction. I hereby release and hold harmless MCDC and its officers, agents, and employees from any and all claims, including bodily injury, death or property damage which may occur due to my or my child’s participation in these volunteer activities. I, the undersigned, my heirs and assigns, hereby covenant and agree to indemnify and hold harmless the MCDC, its officers, agents and employees and all property owners from any and all costs, charges, claims, demands, losses, damages, causes of action, suits and liabilities of any kind, including the expenses of litigation, court cost and attorney’s fees, for injuries to, or the death or illness of any person, or for damage to any property, arising out of or in connection with my involvement in the volunteer activities, regardless of whether such injuries, illness, death or damages are reasonable or unreasonable, or foreseeable or unforeseeable to the parties of the agreement.
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