Name
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First Name
Last Name
Preferred Pronouns
Your Phone Number
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Email
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Zipcode
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Emergency Contact
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First Name
Last Name
Emergency Contact Phone
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Have you volunteered for the Blitz before?
Any health concerns we should know about?
Victory Garden Initiative Permission Slip and Waiver
I hereby agree to participate in the activities, including the construction of raised garden beds, including, but not limited to, digging, lifting, carrying, mulching and moving soil, at properties in the Milwaukee area as part of Victory Garden Initiative Garden Blitz. I understand that my participation in the work with Victory Garden Initiative is completely voluntary.
I understand that due to the physical activities, some of which are strenuous, there is a risk that I may be injured while participating in the project. I hereby acknowledge that should I sustain an injury or illness in connection with my volunteer activities, I will not be afforded any form of medical insurance or workers’ compensation benefits. I fully understand the type of activities which will be taking place during “The Blitz” and agree with and consent to all of the terms for participation set forth and presented to me at the time of orientation.
I agree to release and waive any and all responsibility of Victory Garden Initiative or its officers, agents, or employees, for any accidents or other incidents that may arise out of or occur while I am participating in “The Blitz.” I also understand that I will not be monetarily compensated for any services rendered in connection with the work of “The Blitz.”
I agree to release and forever discharge Victory Garden Initiative, their officers, agents, employees and representatives from any and all liability claims or demands that might arise out of or in connection with: 1) any accident, illness, injury or other consequences or event arising from my participation in this project, or 2) any cause beyond the control of Victory Garden Initiative including, but not limited to, natural disasters, civil disturbances, and weather.
Media Release
I do hereby grant and convey unto Victory Garden Initiative all rights, title, and interest in any and all photographic images and video or audio recording made by Victory Garden Initiative during my volunteer activities with VGI, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
Type Your Full Name as an Electronic Signature
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