Chalk Walk Volunteer Form

Join us AT THE THYEN-CLARK CULTURAL CENTER for our 19th Annual Chalk Walk on Saturday, May 21st (NO rain date).

Please submit this form by no later than Sunday, May 1st. Please fill out a separate form for each volunteer.

Name *

First Name Last Name

Phone Number *

Email *

example@example.com

Emergency Contact Name *

First Name Last Name

Emergency Contact Phone Number *

I would like to volunteer for (can select multiple options): *

Hands-on activity station Registration Event Set-up Event Tear-down

Are you under 18? *

Yes No

The shift that is best for me (can select multiple times): *

Event Set-up (6:00 - 8:00 am) Shift 1 (7:45 am - -11:15 am) Shift 2 (11:00 am - 2:15 pm) Event Tear-down (2:00 - 4:00 pm)

Select Volunteer T-Shirt Size *

Adult S Adult M Adult L Adult XL Adult 2XL Adult 3XL

I/We, for myself, heirs and assigns, do hereby waive, release and discharge any and all rights and claims for damages, including negligence, I may have against the City of Jasper, Indiana, its boards, elected and appointed officials, its employees, and Jasper Community Arts for property damage or personal injury, any claim, damages, expenses or action, including attorney fees, assessed or brought against them because of my acts or omissions during the 2022 Chalk Walk. I agree to assume all risks associated with attending in-person events and to abide by City of Jasper and JCA policies and procedures regarding COVID-19. I agree to follow any established rules or guidelines for the 2022 Chalk Walk.

Participant Signature or Parent/Guardian Signature if under 18 years of age *

Clear