Volunteer with Winfield Isle of Lights, Inc.

Winfield Isle of Lights

November 18th - December 30th, 2018
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Required fields are marked with an asterisk (*)
First Name *
Last Name *
Mobile Phone *

A full 10-digit phone number (for example: 555-123-1234, (555) 123-1234, 555.123.1234, etc)
Is this your first time volunteering for Winfield Isle of Lights? *
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relation to Volunteer *
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I acknowledge that I have voluntarily agreed to participate in the Winfield Isle of Lights
(affiliated organization) Community Service Project, which is scheduled to take place on
November 11-December 31, 2018 in Island Park (City-owned facility, park,
property). I am aware that there are certain risks associated with attending this event, activity
or participating in this program, including but not limited to risk of physical injury, personal
property damage, physical exertion, outdoor exposure and taking various modes of
transportation. In acknowledging these risks and in consideration for attending the event or
activity, I, intending to be legally bound, do hereby for myself, my heirs, executors and
administrators waive and release any and all rights and claims for damages I may have against
the City of Winfield, its employees, officers, officials, representatives, independent
contractors, or volunteers for any and all claims of personal injuries (including death), damages,
or property damage that may occur as a result of attending the event or activity, even though
the liability may arise out of the active or passive negligence on the part of the persons or
entities mentioned above. Further, I will assume my own medical and emergency expenses in
the event of an accident or other incapacity or injury resulting from or occurring from my
participation in the event or activity.
I also understand that photographs or videos may be taken of me during my participation with
this event or activity and that these photographs may be used by the City of Winfield for the
purpose of promoting this event or activity. I hereby consent to use of any photographs or
video taken of me during this event or activity.
My signature on this form indicates that I have read and agreed to the above