Volunteer Waiver Registration
*
indicates required
First Name
*
Last Name
*
Email Address
*
Address
*
Address Line 2
City
*
State/Province
*
Zip Code
*
Preferred Phone Number
*
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone
*
Agreements
*
I do hereby release Fields to Families and all of its supporting farms, organizations and agencies, and all of its directors, officers, agents, staff and volunteers from any and all liability for any and all damages or injuries that may result to my person or property as a result of my role as a volunteer.
Agreements
*
I hereby grant permission to Fields to Families representatives, to take and use: photographs and/or digital images of me for use in news releases and/or educational materials.I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives,prints, digital reproductions shall be the property of Fields to Families.
