Community Benson Park Cleanup Volunteer Registration Form

Community Benson Park Cleanup Volunteer Registration Form

Fill out the form carefully for registration
Your Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Can we add you to our Newsletter and Text List?
How Many Volunteers in Your Party?
PHOTO CONSENT & RELEASE

I hereby consent and agree that Leave It Better Than You Found It, a Nebraska 501c3, (Event Host) and Woodmen Life (Event Sponsor) has the right to take or use photographs of me (and/or my property) and to use these in any and all media worldwide incuding online, now or hereafter known, and for any purpose whatsoever.

I hereby release to the (Event Host) and (Event Sponsor) all rights to exhibit this work in print and electronic form publicy or privately and to market copies. I agree to be contacted by the (Event Host) and (Event Sponsor). I waive any rights, claims or interest I may have to control the use of my identity or likeness in the photographs and agree that any uses described herein may be made without compensation or additional consideration of me.
Signature
Please verify that you are human
Should be Empty: