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CBC Volunteer Day Registration Form
1
Full Name
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First Name
Last Name
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2
Other Family Members Joining You?
If yes, please let us know the names (and ages if under 18) of your family/friends members volunteering with you.
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3
Address
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Street Address
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State / Province
Postal / Zip Code
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Portugal
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Rwanda
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Saint Helena
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Samoa
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eSwatini
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Switzerland
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Taiwan
Tajikistan
Tanzania
Thailand
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Togo
Tokelau
Tonga
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Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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4
E-mail
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5
Phone Number
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Area Code
Phone Number
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6
What types of work are you willing to be involved in?
Wood chips/Mulching
Clearing paths / boardwalks
Weeding
Inside work / light work
Other
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7
Any Special Comments
Please let us know if you have preferences in work projects or limitations that we should take into consideration.
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8
Volunteer Release / Waiver
*
This field is required.
We are most grateful for your time and commitment to helping us with our site and programs. Thanks to volunteers we accomplish a lot more and improve the campus to benefit all camp participants and generations to come.Camp Beech Cliff MDI strives to have all work conducted safely, whether by paid staff, contractors, or volunteers. By signing this statement, you acknowledge that you are aware that there is an element of risk inherent in all activities, particularly in working with or around any machinery such as power tools, tractors, chippers and the like. For the safety of our volunteers, we ask that you only handle equipment which you know how to operate competently and safely, and you will take personal responsibility for your own actions with that equipment.I understand that my participation in volunteering can expose me to danger both from unknown and unanticipated risks. Acknowledging that such risks exist, I hereby waive, release, absolve, indemnify and agree to hold harmless Camp Beech Cliff and Camp Beech Cliff MDI, their respective directors, officers, agents, volunteers and employees, from any and all claims or liability for personal injury or damage I may suffer while participating in camp activities. I specifically agree to release and hereby release Camp Beech Cliff and Camp Beech Cliff MDI and its directors, officers, agents, volunteers and employees from any negligence of the camp. Any legal action must be in the State of Maine statues.
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9
Photo Release
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For good and valuable consideration, I hereby consent to and authorize the reproduction, publication, and use by Camp Beech Cliff and their successors and assigns, for advertising, commercial, and promotional use and any other purpose the photo, picture, or likeness of myself and/or my child(ren).
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10
Waiver/Release Signature
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Please acknowledge acceptance of waivers and releases by entering name below.
If under age 18, this must be 'signed' by a parent or guardian.
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