Champlain Park Environment Volunteer Registration form

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Environ-teer Member Registration, Project Activity Disclaimer and Privacy Agreement form.

Please complete the form answering all the required questions .

You will be contacted by one of our Project Coordinators.

We thank you for wishing to become a Volunteer team member.

More information can be found at: https://champlainpark.org/environteers/

Email *

Please enter your Contact information:

Phone Number *

First name(s) *

Last name *

Address (number and street) *

CPCA Project Activity Disclaimer Form

Please complete all the questions below and submit the form. Thanking you in advance for your interest in participating in Environment projects…

1) I do hereby release the Champlain Park Community Association (CPCA), its members, officers, directors, employees, volunteers and independent contractors from all liability, claims, causes of action of any kind whatsoever in respect of all personal injuries, loss of life or property losses which I may suffer arising out of this activity. *

Yes

2) And I do hereby acknowledge and agree: *

Yes

That this activity may be dangerous and expose me to risks and hazards.

That I freely and voluntarily assume all the aforesaid risks and hazards.

That I understand clearly that by submitting this form Release I will be forever prevented from suing or otherwise claiming against the Association, its Members, officers, directors, employees, volunteers or independent contractors with respect to any matter a rising from this activity.

This disclaimer form applies for the duration of being a member and participating in volunteer project activities

Yes

That this activity may be dangerous and expose me to risks and hazards.

That I freely and voluntarily assume all the aforesaid risks and hazards.

This disclaimer form applies for the duration of being a member and participating in volunteer project activities

Privacy Agreement

Do you agree to give us permission for the following? *

Yes

Do you agree to give us your permission to be allowed to post pictures of you, or present in team photos on our website, twitter and our social media communication channels?

Do you agree to give us your permission to publish your name on our website, twitter or social media communication channels?

Volunteer Environ-teer Member Agreement

That I have carefully read this Release, Waiver and Assumption of Risk and Indemnity agreement, that I fully understand same, and that I am freely and voluntarily executing same. *

Yes

Please enter Agreement date below for submitting this form *

YYYY

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

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