WCSC - Test | Scott County Iowa

Event Date

Monday - 12/13/2021

Start Time

8:00am

End Time

11:00am

Address

5640 Carey Avenue Davenport, IA 52807

Event type

Testing website function for event request

Meet Up Location

Testing website function for event request

Registration for event

First Name

Last Name

Email

Mobile Phone

Register Additional Family Members

If you have additional family members, add them below. If you have a large group, please contact us to get set up.

First Name

Last Name

Volunteer Two Email

First Name

Last Name

Volunteer Three Email

First Name

Last Name

Volunteer Four Email

First Name

Last Name

Volunteer Five Email

First Name

Last Name

Volunteer Six Email

LIABILITY RELEASE AND WAIVER

By registering for and participating in this cleanup I agree I will not hold any coordinating or sponsoring organization or their officers, employees and agents, or any other volunteer associated with any cleanup activities whether as a result of their negligence or the negligence of others, responsible for any injuries or damages that may occur as a result of participation.

I understand and agree the activity I am participating in is one where the possibility exists, however slight, that injury could occur. I am in adequate physical condition to engage in this activity.

I give permission for my likeness captured on video, photo and digital camera during the event to be used solely for the purposes of promoting the event on their Web site or in any promotional material or publications, and waive any rights of compensation or ownership.

I understand this is a volunteer activity and will receive no compensation of any kind for labor rendered during this cleanup.

I have completed this release and waiver for myself and my child/children under the age of 18.

By checking this box I agree that I have read the following and agree to each item. *A parent or guardian is required to complete this release and waiver for volunteers under 18 years of age.

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