Silver Birch Ranch Volunteer Request Form

Silver Birch Ranch Volunteer Request Form
NOTE: Each volunteer ages 18 and older must fill out this form individually.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Are you currently at least 18 years old?*

YesNo
I plan to volunteer the following days
I plan to arrive on:*

MonthDayYear
Date
I plan to depart on:*

MonthDayYear
Date
Will you be eating camp meals?

YesNo
ATTENTION: We will attempt, to the best of our ability, to accommodate volunteers (medical food-related allergies only) with gluten-free and dairy-free needs. Please contact our Food Service Director, Jake Scheich, 7 days prior to volunteering, at foodservice@silverbirchranch.org or call him at 715-484-2742 ext. 239.
Please select any allergies that apply:

NoneGluten FreeDairy

Visitor Release Form

Silver Birch Ranch, Inc. (“SBR”) is committed to the safety and well-being of everyone who is involved in any aspect of our ministry. From time to time events may occur where medical care or treatment is necessary for an individual while they are involved in this ministry.
By signing this document you are agreeing to the following:

I agree to hold SBR, its ministries, and its agents harmless and free from any liability from any such event.
For any minors other than my children (“charges”), it is assumed by SBR that the child(ren) has their parent’s permission to be in my care (as their guardian). I assume all responsibility and liability for the child(ren) while at SBR.

I realize that many of the activities at SBR are potentially dangerous and will participate, and allow my child(ren) and/or charges to participate in them knowing of this danger. I will accept personal responsibility for any and all injuries incurred by myself, my child(ren), or my charges, signed below while at camp.

In the event of a medical emergency, I understand and agree that I, and any of those for whom I have signed below, will be entered into the local Emergency Medical Service (EMS) system.

I give SBR the authorization to use my image, and any of those named below, for promotional purposes.

I give SBR the authorization to contact me via e-mail (if e-mail address is provided).
Emergency Contact*

First NameLast Name
Phone Number*
List family members and/or those in your care below (if applicable):
Name

First NameLast NameRelationship
Name

First NameLast NameRelationship
Name

First NameLast NameRelationship
Name

First NameLast NameRelationship
I have read, understand, and agree with the above statements for myself and any minors in my care:
Digital Signature*

First NameLast Name
Today's Date*

MonthDayYear
Should be Empty:

Silver Birch Ranch Volunteer Request Form

Visitor Release Form