25th Annual Race for Open Space Volunteer Sign-Up

Full Name

First NameLast Name

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Date of Birth

Date

Which day(s) and time(s) are you available to volunteer?

Additional Comments or Preferences

*For Volunteers Who Are 16-18 Years Old:
I am the parent / guardian of the above-named volunteer and give permission for them to participate as a volunteer.

Printed Name    First Name   Last Name       Signature   Signature
Relationship to Volunteer:   Type a label

Cell #:   Area Code   Phone Number

I DO / DO NOT give permission to use my likeness and publish my name in the media.

Emergency Contact Name: First Name* Last Name*
Emergency Contact Phone Number: Area Code* Phone Number*

*I acknowledge that in participating in the Nantucket Conservation Foundation volunteer program, specifically Race for Open Space, there exists a risk of injury including physical harm, and that all activities performed by me will be done at my own risk. I have read and understand, and agree to, the following Release of Claims, Indemnity and Hold Harmless Agreement.

I First Name* Last Name* , in consideration of my participation in the Nantucket Conservation Foundation Race for Open Space volunteer program, and for other good and valuable consideration hereby acknowledged, do hereby agree on behalf of myself, my heirs, and personal representatives, to forever RELEASE the Nantucket Conservation Foundation and its successors, assigns, employees, agents, staff, representatives, officers, volunteers, or contractors (the “Releasees”), regardless of title, assisting in the operations and activities of the Foundation, from any and all claims, actions, rights of action and causes of action, damages, costs, loss of services, expenses, compensation and attorneys’ fees that may have arisen in the past, or may arise in the future, directly or indirectly, from known and unknown personal injuries or property damage which I may have as the result of my participation in the operations and activities of the NCF.
I further acknowledge that such participation is voluntary and may expose me or my property to the risks resulting from my activities, the activities of other participants, or the conditions under which activities are performed. With knowledge of these dangers, I promise, to INDEMNIFY, REIMBURSE, DEFEND, and HOLD HARMLESS the Releasees against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, including damages, costs and attorneys’ fees, arising from personal injuries to myself or others or property damage resulting from my participation as a participant or in the administration of first aid.
I hereby further covenant for myself, my successors, assigns, heirs and personal representatives not to sue the said Releasees on account of any such claim, demand or liability.
I am fully aware that by signing this document I am releasing the above-mentioned parties from liability that may arise as a result of intentional or negligent acts of these parties. Additionally, it is my intent to release the above-mentioned parties from liability and defend and indemnify said parties for liability relating to any accident and resulting injuries and/or death that may occur as a result of my participation in the Nantucket Conservation Foundation project.

Signature