Bird Count Volunteer Waiver

Thank you for participating in wildlife monitoring at the Sharing Our Roots Farm!

All farm event attendees and volunteers must fill out the below form before participating in farm activities.
Information will be securely stored and never shared or sold.

Please direct any questions to margaret@sharing-our-roots.org.

Name

First Name

Last Name

Email

Phone

(will only be used in case of last-minute cancellation)

(###)

###

####

Emergency Contact Name:

Emergency Contact Phone Number:

Liability Waiver

I, the undersigned, agree to participate in the above-named program in accordance with all rules and regulations. In consideration I hereby, for myself, my heirs, executors, assigns, and administrators, waive and release any and all rights and claims that I may have, or may arise, against Sharing Our Roots, their sponsors, agents or representatives, for any and all injuries or losses suffered by me in connection with the activity covered by this roster. I understand that certain activities are physically challenging and potentially dangerous and I assume all risk associated with my participation. Additionally, I represent that I am physically and emotionally capable of performing the activities. To electronically sign, please type your first and last name below:

Media Release

I give my permission to Sharing Our Roots to use any photos and videos of my participation in Sharing Our Roots events for marketing and advertising, such as on promotional materials, annual reports, brochures, newsletters, website, and social media. To electronically sign, please type your first and last name below. If you choose to not sign, please check in with a staff member upon arrival for a special nametag.

Please include any accessibility needs or accommodations: