Volunteer Registration Form
*
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 Phone
Emergency Contact Relationship
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.
