AMI Hurricane Relief Application
Coastal Guardians Alliance is holding one final weekend event for residents of Anna Maria Island (AMI)!
Saturday & Sunday, 11/9 & 11/10.
If your residential property or business has been effected by Hurricane Helene or Milton, please fill out the form below. We will reach out to you once volunteers are assigned.
We will do our best to fulfill all requests. Our ability to do so is dependent on volunteer participation.
Please note that supplies are not included.
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What is your full first and last name?  *
What is the best phone number to reach you?  *
Is your location a personal residence or business? *
If your location is a business, what is the name?
What is the address of your residence or business in need of relief? (please include the full address including street, city, state and zip code) *
What service(s) do you need? Add as much detail as you can. Details will aid in our ability to fulfill your request. *
How many volunteers do you need for this project?
We will do our best to match your request.
*
Which days are you available to host this project? Select all that apply. 

Please note that by only picking one or two day(s), you may be limited by the availability of our volunteers.

If your availability increases from original submission, please submit a new form with updated availability.

If your availability decreases from original submission, please contact coastalguardians941@gmail.com.
7AM-10AM
10AM-1PM
1PM-4PM
4PM-7PM
Sat Nov 9
Sun Nov 10

Waiver and Release of Liability:

I hereby acknowledge that I am voluntarily participating in the activity described above. I understand that this activity may involve risks, including but not limited to injury, illness, property damage, or death. I assume all risks associated with my participation, and will not pursue any action against Coastal Guardians Alliance or its volunteers regarding any activity that takes place on my Property pursuant to the volunteer’s work. I hereby grant all volunteers a right of entry on my Property to complete the necessary work agreed to by myself and Coastal Guardians Alliance. I further acknowledge that all work done by Coastal Guardians Alliance is done strictly by volunteers, for which no payment is to be made. At no point in time will I demand any payment from Coastal Guardians Alliance or its volunteers regarding any work done on my Property.

I understand that this Release discharges Coastal Guardians Alliance from any liability or claim that the I may have against Coastal Guardians Alliance with respect to any bodily injury, personal injury, illness, death or property damage that may result from activities with Coastal Guardians Alliance, whether caused by the negligence of Coastal Guardians Alliance or its officers, directors, employees, volunteers, or agents or otherwise. I also understand that Coastal Guardians Alliance does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury or illness.

I understand that the activities include work that may be hazardous to myself and my property. I hereby expressly and specifically assume the risks, damages, injury or harm that may result from Coastal Guardians Alliance activities, and I release Coastal Guardians Alliance from all liability for injury, illness, death or property damage resulting from its activities.

I do hereby grant and convey unto Coastal Guardians Alliance all rights, title and interest in any and all photographic images and video or audio recordings made by Coastal Guardians Alliance during the activities with Coastal Guardians Alliance, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

I expressly agree that this release is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that this Release shall be governed by and interpreted in accordance with the laws of the State of Florida. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdictions the invalidity of such clause or provision shall not otherwise direct the remaining provisions of this release which shall continue to be enforceable.

In consideration of being allowed to participate in this activity, I hereby release and hold harmless Coastal Guardians Alliance, its officers, employees, agents, successors, assigns, and volunteers from any and all liability, damages, claims, and demands of whatever kind of nature, either in law or in equity, which have now or may hereafter arise as a result of my participation in this program. This includes, but is not limited to, any damage to my real property or personal property.

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Required
Photography Release Waiver:
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Required

Waiver and Release of Liability:

Please sign below. By providing your printed name, you agree that it will serve as your signature.
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