NCA Minor Liability Waiver and Photo Consent Form
Thank you for your interest in volunteering or attending one of our tours! Please read this document carefully and completely. By signing this agreement, you waive certain legal rights. The signature of a legal guardian is required for all minors who wish to participate in this volunteer event. If you do not feel able to attend after reading this waiver, please cancel your eventbrite ticket so that another person may attend. If you'd like some clarification about the event's activities, communicate additional access needs, or have access questions, please email info@newtowncreekalliance.org. We're looking forward to seeing you!
Participant's Name (Preferred)
Participant's Legal Name
First
Last
Participant's Age
Guardian Name
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First
Last
Guardian's Email
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Would you like to be added to our email list?
Yes
No
Guardian Phone Number
*
Format: (000) 000-0000.
Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any Relevant Community Affiliations (school, organizations, etc):
Emergency Contact Information:
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Name
Phone Number
Emergency Contact Relationship (neighbor, grandparent, auntie/uncle, etc)
Does the participant have any medical information or access needs that we should be aware of when assigning your responsibilities?
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Yes
No
If you answered yes to the above question, please provide that information:
I, being the parent or guardian of the participant who is volunteering for Newtown Creek Alliance (NCA), understand that I am responsible for all actions of the participant. I will communicate to them what is expected of them at NCA's events as outlined below in this waiver.
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I acknowledge my responsibilities as guardian
When participating in this volunteer program, the participant will cooperate promptly and fully with all reasonable directions of NCA personnel. The participant must follow all applicable City, State, and Federal laws, rules, and regulations. The participant understands that failure to behave appropriately may result in being prohibited from further participating in this or other NCA activities. I understand the nature of the activities that the participant will be involved in to participate in the various types of activities hosted by NCA, including, but not limited to: heavy lifting, use of wheelbarrows, shovels, rakes, grabbers or construction tools to remove trash and debris from the site, remove invasive or otherwise unwanted plant material, and install NCA provided/approved plant material.
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I have read these terms and acknowledge that I am liable
The participant is aware that volunteering at or attending NCA events will require them to be outside for a few hours. The participant is prepared to stand or crouch for long periods of time, walk long distances, or otherwise be mobile and physically engaged in appropriate weather. I represent that the participant is physically fit and does not have a medical condition that would restrict him/her/them from participating in these types of physical activities. I acknowledge that there are risks associated with physical activities of this nature, including the risks of serious bodily injury and death, and I hereby assume all dangers and risks associated therewith. I attest that the participant knows to only perform tasks that he/she/they feel comfortable and safe doing, and that the participant is medically and physically capable of doing. I also understand it is my responsibility to ensure their safe travel to and from the volunteer site and shall not hold NCA responsible for any injury they might sustain as a result of travel to and from the volunteer site. I understand that NCA is not responsible to cover any medical expenses due to injury received through the participant’s volunteer activities.
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I have read these terms and acknowledge that I am liable
I hereby agree to waive all claims the participant or I have or may have against NCA or property owners/operators in relation to volunteer programs, and agree to release and hold harmless NCA, along with their respective trustees, directors, officers, employees, agents, associates, corporate sponsors other representatives, from any and all claims for any and all expenses, personal injury, loss, or damages incurred during or in connection to participation in this volunteer program. I also agree not to bring any legal actions against the nonprofit parties based upon my participation in NCA programming.
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I have read these terms and acknowledge that I am liable
By participating in an event or program of NCA, I understand that photography, audio, and video recording may occur. I grant consent for the participant to be photographed, filmed, and/or otherwise recorded, and to the release, publication, exhibition, or reproduction of any and all recorded media of his/her/their appearance, voice, and name for any purpose whatsoever in perpetuity in connection with NCA and its initiatives, including, by way of example only, use on websites, in social media, news, and advertising. There shall be no compensation, financial or otherwise, for this appearance, voice, or name. I waive and release any claims the participant or I may have related to the use of recorded media of them at the event, including, without limitation, any right to inspect or approve the photo, video, or audio recording, any claims for invasion of privacy, violation of the right of publicity, defamation, and copyright infringement, or for any fees for use of such record media. I understand that all photography, filming and/or recording will be done in reliance on this consent.
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I consent their being occasionally photographed and/or video and/or audio recorded by NCA staff members, and those likenesses being used by NCA and/or its grantors
I would not like their likeness used for NCA or grantor purposes. I acknowledge that it is my responsibility to tell all NCA staff at the event that I have opted them out of recording. I acknowledge that it is my responsibility to inform NCA staff each time I participate in NCA events that I have opted them out of recording. I will remind them before each volunteer event to not join group photos or recordings that staff are taking, and ensure that they do their best to stay away from whenever and wherever a staff member is documenting the event.
Today's Date
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Month
-
Day
Year
Date
Guardian's Signature
*
Submit
Should be Empty: