ENV Events Volunteer Signup

Registration Form & Waiver for City of Battle Creek Environmental Events
Recycle Events will be held at 150 Kendall St. S, Battle Creek, MI 49037, the Department of Public Works. Earth Day Cleanup and Krazy for the Kazoo locations TBA.

Contact Patty at pjhoch@battlecreekmi.gov or 269-966-3355 x1878 with any questions.
Volunteer Information

Note: This form only needs to be completed by those volunteering to work the event.
Registrant Information*
Group Name or Affiliation*
Scout Troop #, Church, Company, School (NHS), etc.
I am signing up a group and will be the contact person/crew leader for that group.*

YesNo
Group Member(s)*
Volunteer Availability

Tasks can include: checking in participants, handing out information, unloading vehicles, sorting materials/tires, directing traffic, trash collection.
Please select all that apply.*
Emergency Contact Information
Emergency Contact: *
Relationship*
Emergency Contact:*
Add any extra information you feel we should know.
Allergy (Bees or Poison Ivy), Health/Behavioral Condition, Dietary Needs/Restrictions, Activity Restriction:
Please list all that apply.
RELEASE OF CLAIMS WAIVER FORM

I fully understand that by signing this liability disclaimer, I, on behalf of myself and my agents, my group members, heirs and next of kin, assume all risks and hazards incidental to my participation in this activity, including transportation to and from these activities. I do hereby waive, release, absolve, indemnify, and agree to hold harmless, collectively, and individually, the City of Battle Creek, and Calhoun County from any claim arising from sickness, injury or death to me or my property except if caused by their gross negligence or willful and wanton misconduct.

I agree that if the City of Battle Creek, and Calhoun County are sued by anyone else because of claimed conduct of myself, I will indemnify the City of Battle Creek, the City of Springfield, and Calhoun County for all damages and costs, including attorney’s fees.
Confirmation

I HAVE READ AND UNDERSTAND THE AGREEMENT.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature of Registrant (Signature from Parent or Guardian if under 18).*

Clear
Date*

MonthDayYear
Any questions or comments about your registration:
We thank you for all you do!

bcwater.org
Should be Empty:

Registration Form & Waiver for City of Battle Creek Environmental Events

Recycle Events will be held at 150 Kendall St. S, Battle Creek, MI 49037, the Department of Public Works. Earth Day Cleanup and Krazy for the Kazoo locations TBA.

Volunteer Availability

Add any extra information you feel we should know.

RELEASE OF CLAIMS WAIVER FORM

We thank you for all you do!