Volunteer dates and times: *

Select all the dates and times you are available to help. Note: If capacity has been reached for an event it will no longer show on the list of date choices below.

January 29 (Wed) from 9:00am - Noon - Olympic Discovery trail in Agnew

Name *

Please fill out a separate volunteer form for each family member participating.

First Name

Last Name

Phone *

(###)

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Name of Emergency Contact (or parent/guardian if volunteer is a minor)

First Name

Last Name

Phone Number for Emergency Contact

(###)

###

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Release of Liability *

By checking the box below, I agree to indemnify and hold the landowners, Clallam Conservation District, its employees, its elected and appointed officials, any other third party involved with the event, and other event participants harmless from and against any liability, claim, injury, or costs arising from or resulting from my work as a volunteer and/or attendance at an education event. Furthermore, I acknowledge there are potential hazards associated with volunteer activities and/or participation at educational events and I agree to exercise common sense and follow all safety precautions to avoid accident and injury. I will contact the project leader(s) in case of an accident or if I observe safety hazards or violations.

I acknowledge I have read and agree to Clallam Conservation District’s Release of Liability as presented above.

Health Safety *

If indicating any of the following symptoms I will not attend the event: Fever, chills, cough, shortness of breath, fatigue, muscle pain, headache, loss of taste or smell, sore throat, stuffy or runny nose, nausea, vomiting, diarrhea.

I acknowledge that I have read and agree to Clallam Conservation District’s Health Safety protocol as presented above.

Photo Release *

I give my permission to have my photo or my child’s photo taken during this event and used for publicity purposes for hosts or sponsors.

Yes

No