2018 VOLUNTEER FORM

All volunteers of Wildlands Trust must fill out this form electronically or in person at the Wildlands Trust headquarters or at a Wildlands Trust volunteer event. Forms must be resubmitted annually.

This volunteer waiver is for adults 18+ years of age. If you are under 18, a youth waiver must be filled out in person or via mail with a parent/guardian signature.

Name *
Name
Address *
Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Emergency Contact Information
Name
Name
Primary Telephone Number
Primary Telephone Number
Secondary Telephone Number
Secondary Telephone Number
Liability Waiver: In consideration of permission to participate in Wildlands Trust volunteer opportunities: *
• I fully understand and acknowledge that outdoor activities have inherent risks, dangers, and hazards that may exist during my participation. • Participation in such activities may result in injury or illness. By participating in these activities, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence of the officers, staff, or agents of Wildlands Trust, the negligence of the participants, the negligence of others, accidents, the forces of nature, or other causes. • I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Wildlands Trust and its officers, staff, and agents from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, or otherwise which may arise out of my participation in Wildlands Trust activities. • In signing this form, I give permission for Wildlands Trust staff to administer any routine and/or emergency first aid. I understand that every effort will be made to contact a named emergency contact, but in the event that they cannot be reached, I hereby give permission to Wildlands Trust staff to hospitalize and/or secure proper medical treatment as needed. • I hereby consent that Wildlands Trust may use any narratives, film, photographs, videotape, or sound recordings of events in which I may be participating in order to publicize events, programs, and volunteerism.