2019 Wheels for Meals Ride
Sign in to Google to save your progress. Learn more
Full Name *
Best Contact Number *
Email Address *
We'd like to tag you on our social media posts. Don't forget to like us on Facebook and follow us on Instagram & Twitter.
Your Facebook URL
Your Instagram Name
Your Twitter Handle
Your T-shirt Size *
Please add any comments or anything else we should know about you or your availability.
Emergency Contact & Phone Number *
I have read, understand and agree to the following: I wish to volunteer on Saturday, October, 26 at Shadow Cliff's Regional Park in Pleasanton. I understand that my attendance at and involvement in event activities will be performed strictly on a voluntary basis, without pay, compensation, or benefits. I grant full permission for MOWAC and its officers and directors, partners, employees, agents, and volunteers (“Releasees”), to use my image, audio and quotes for promotion of this event and other MOWAC activities. I hereby waive my right of publicity in connection with such uses. I agree and understand that I must comply with MOWAC's policies, generally accepted rules of safety and verbal project instructions. Failure to comply may result in my immediate dismissal as a volunteer. I understand that MOWAC does not provide Workers’ Compensation Insurance coverage for volunteers as it isn’t required to do so by the law. I’m aware of the nature of the activities I’ll perform and recognize that as with all physical tasks there’s potential for/risk of injury. I attest that I’m physically able and prepared for event-related activities or that if accommodation is needed that I have made that request in writing to MOWAC. Further, I understand and agree that activities performed are at my own risk and I assume full responsibility therefore. On behalf of myself, my heirs and all personal representatives, I agree not to hold or attempt to hold MOWAC, its staff, officers, volunteers, and other representatives responsible for any injury or damage sustained/incurred, arising out of or in any way connected with my event volunteerism. I hereby release and discharge MOWAC, its staff, officers, volunteers, and other representatives from any and all claims, demands, causes of action of any nature or cause for any such injury or damage incurred or suffered. This release also applies to any damage, destruction, loss or theft of personal property resulting from my own negligence, the negligence of others, or from accidents without negligence. I agree to release and hold Releasees harmless from any cause or action, claim or suit arising there from. I HAVE READ ALL OF THE ABOVE TERMS AND CONDITIONS. BY ANSWERING "YES" I AM AGREEING TO ALL OF THESE TERMS AND CONDITIONS. * *
I am over 18 years of age and I warrant that I have legal authority to execute this agreement. If you answer "no" we'll email you a parent consent form. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Meals on Wheels for Alameda County. Report Abuse