Name *

If under 18, a parent or guardian must fill out this form.

First Name

Last Name

Phone

(###)

###

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Acknowledgment of Risk *

1. Acknowledgment of Risk I understand that as a volunteer with Iowa Valley RC&D, I may be participating in outdoor activities including, but not limited to, gardening, planting, weeding, harvesting, using hand tools, lifting heavy materials, and working in varying weather conditions and terrain. I acknowledge that these activities involve inherent risks, including but not limited to minor injuries (cuts, scrapes, insect bites), heat exhaustion, allergic reactions, and more serious injuries resulting from the use of tools or uneven terrain.

I Consent

Assumption of Risk *

2. Assumption of Risk I voluntarily assume all risks associated with participating in any volunteer activity with Iowa Valley RC&D. I understand that these risks may include physical or emotional injury, illness, permanent disability, or death, and I assume full responsibility for my participation.

I Consent

Waiver and Release *

3. Waiver and Release In consideration for being allowed to participate in volunteer activities, I hereby release and hold harmless Iowa Valley RC&D, its directors, officers, employees, agents, partners, and affiliates from any and all liability, claims, demands, or causes of action that may arise from or relate to any injury, illness, damage, or loss I may sustain while participating in any Iowa Valley RC&D activity, whether caused by negligence or otherwise.

I Consent

Medical Treatment *

4. Medical Treatment I authorize Iowa Valley RC&D to seek emergency medical treatment on my behalf if I am injured or become ill while participating in volunteer activities. I understand and agree that I am responsible for any medical costs incurred as a result of such treatment.

I Consent

Insurance *

5. Insurance I understand that Iowa Valley RC&D does not provide health or accident insurance for volunteers and that it is my responsibility to obtain my own health insurance coverage.

I Consent

Media Release

I grant permission to Iowa Valley RC&D to use photographs, video, or audio recordings of me taken during volunteer activities for use in promotional materials, including print, web, and social media.

I do not grant permission to use my likeness in any promotional materials.

Code of Conduct *

7. Code of Conduct I agree to follow all safety protocols, instructions, and guidelines provided by Iowa Valley RC&D staff or site supervisors. I will conduct myself in a respectful and cooperative manner toward staff, other volunteers, and program participants.

I Consent

If applicable, Parent/Guardian Name:

First Name

Last Name