Volunteer Registration Form

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Email *

Which of the following volunteer landcare areas most interest you? Tick as many as you like *

Beach Clean-ups

Mangrove Watch Monitoring

Flora and Fauna Surveys

Weed Control

Roadside Clean-ups

Water Quality Monitoring

Coral Monitoring

Required

Would you be interested to attend a monthly Networking event? An opportunity to discuss ideas and plan events *

Yes

Full Name (First and Last name) *

D.O.B *

YYYY

Phone Number *

Email *

Are you attending with friends / partner / family? *

Yes (if yes, please enter their names below)

Full Name (First and Last name)

Emergency Contact Person (First and Last name) *

Phone Number *

Do you have any pre-existing medical conditions? *

Yes

Details of pre-existing medical conditions, allergies and past injuries (if none, write N/A) *

MEDIA RELEASE CONSENT

I give permission to South Cape York Catchments Inc. to collect, use and disclose my images and/or voice and personal information, and specifically for SCYC to disclose the images and personal information to the Australian Government for its use for publications for promotional and information purposes, including but not limited to:

Reports, books, brochures, research, publications, zoning maps, newsletters, fact sheets, e-promotions, calendars, PowerPoint presentations, advertising, public displays, television or radio advertisement/programs, promotional products, posters, billboards, internet, media (including social media) and possible supply to a third party.

I agree that my personal information may be utilised in any of the above-mentioned purposes which may result in my identification. I also understand that once my personal details are utilised for an official purpose, SCYC have no control over its subsequent use and/or disclosure.

I release and discharge SCYC from and claims or demands that could be made in connection with the use of my personal information for an official purpose referred to above.

Privacy Statement: The personal information submitted on this form is collected by SCYC for the purpose of obtaining your consent for using, disclosing and publishing your personal information. Except in the carrying out of an official purpose, SCYC will not otherwise disclose your personal information to any third party, without your consent, unless it is required to do so by law.

SCYC's Privacy Policy contains information about how you may:

access and seek correction of your personal information and complain to SCYC about a breach of the Australian Privacy Principles and how SCYC will deal with such a complaint.

Media Release Consent *

Yes

Some volunteers events provide food, please select your dietary requirement below *

Celiac

Vegan

Vegetarian

No dietary requirements

Required

Are you a member with South Cape York Catchments? *

Yes

If you are not already a member, please select yes if you would like to be added to our database *

Yes

Would you like to join our mailing list? We send about 5-6 newsletters out per year, sharing stories from our rangers, trainees, volunteers and upcoming events *

Yes

CONDITIONS OF PARTICIPATION

The participants / legal guardian signed below agree that South Cape York Catchments Inc will not be
liable for:

• any injuries sustained by the participant
• any loss or damage to property owned by, or in the possession of, the participant.
• any acts or omissions, negligence or fault of any person participating in the clean-up.

The participant or legal guardian signed below agrees that they;

• will take reasonable care for their own safety;
• were given and understood the safety briefing by the site supervisor prior to commencing the clean-up and will comply with it
• will accompany and supervise all volunteers under the age of 18 years or who are registered under their signature;
• will wear sturdy enclosed footwear, gloves and protective equipment as advised by South Cape York Catchments Inc;
• will not do anything to harm themselves or other volunteers;
• will not handle syringes or other sharps but will inform the site supervisor immediately;
• will use all safety equipment they are given;
• will obey all lawful directions and instructions of the site supervisor or other clean-up officials have told the site supervisor of any pre-existing medical conditions that might affect their participation in the clean-up;
• are not affected by drugs or alcohol.

I agree to terms and conditions *

Yes

Required

Type your name below as a form of digital signature *

Date *

YYYY

To confirm you are not a spam bot please answer: 2 plus 3 = *

A copy of your responses will be emailed to the address you provided.

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This form was created inside of Cape York Non Profit.