Williamsburg Botanical Garden Volunteer Application

Williamsburg Botanical Garden Volunteer Application

CONTACT INFORMATION

DATE

Name

Address

City / State

Zip Code

Telephone (h)

(c)

(w)

Email Age Range

under 12

12-17

18-24

25-54

55+

How did you hear about WBG?

Have you been referred to volunteer by a court order? Yes

No

PROGRAM INTERESTS Communications Photo Team

Development Special Events

Education Administrative

Garden Crew Board Member

GARDENING SKILL & KNOWLEDGE LEVEL Beginner VCE Master Gardener

Intermediate Master Naturalist

Advanced Advanced Education

AVAILABILITY

SUN

MON

TUES

WED

THUR

FRI

SAT

Morning

Afternoon

SPECIAL SKILLS or TALENTS

PROVIDE TWO REFERENCES

Name 1

Email

Name 2

Email

Relationship Phone Relationship Phone

Mail to: WBG Volunteers - P.O. Box 1577, Williamsburg, VA 23187-1577 OR Scan your completed form and email to WBGvolunteers@

Volunteer Application, Waiver Agreement, Emergency Info - v: 05-23-2019

Waiver and Release of Liability and Indemnification Agreement between Volunteer and the Williamsburg Botanical Gardens

This waiver and release of liability and indemnification agreement is between the Volunteer or the Volunteer's guardian and the Williamsburg Botanical Garden (hereafter referred to as "WBG"), 5537 Centerville Road, Williamsburg, VA 23188, and its directors, officers, members, employees, agents, assigns, legal representatives, and successors. This agreement applies anytime the Volunteer undertakes or expresses a willingness to undertake a service at or for WBG.

As a volunteer who is 18 years or older, or as the parent or guardian of a volunteer younger than 18, I understand and agree to the following: I WAIVE and RELEASE WBG from any and all liability, claims or demands for any reason of illness, death, damage, loss, or injury to my person and property that has been or may be sustained as a direct or indirect consequence of volunteering at or for WBG regardless of whether that damage, death, illness, loss or injury may have been caused wholly or partly by the negligence of WBG or some other party. I agree to indemnify WBG for any and all liability claims, demands or costs that WBG may incur as a result of my volunteering or the minor for whom I am responsible volunteering for WBG.

By signing this application, I grant WBG the irrevocable and unrestricted right to use and publish photographs of me or of the minor for whom I am responsible, or photographs in which I or the minor for whom I am responsible may be included, for promotional purposes in any manner and medium without my inspection or approval. I release WBG from all claims and liability related to those photographs.

I acknowledge and agree that I have carefully read this Agreement, that I fully understand it, and that I freely sign it. I understand that I may seek independent advice prior to signing this Agreement. I understand this Agreement is binding on me, my executors, administrators, personal representatives, and assigns and that this Agreement has important legal consequences. The terms of this Agreement are contractual and not mere recitals. This Agreement will be governed by the laws of the Commonwealth of Virginia.

Signature

Date

Printed Name:

Signature of Parent or Guardian if under 18 years old

Date

Printed Name of Parent or Guardian:

Mail to: WBG Volunteers - P.O. Box 1577, Williamsburg, VA 23187-1577 OR Scan your completed form and email to WBGvolunteers@

Volunteer Application, Waiver Agreement, Emergency Info - v: 05-23-2019

VOLUNTEER INFORMATION

DATE

Name

Address

City / State

Zip Code

Telephone (h)

(c)

(w)

Age Range under 12

12-17

18-24

25-54

55+

LIST ANY MEDICAL CONDITION OR ALLERGY WE SHOULD KNOW ABOUT IN CASE OF EMERGENCY:

EMERGENCY CONTACT INFORMATION Name Relationship Telephone Primary number to call:

Additional number(s) to call:

Name Relationship Telephone Primary number to call:

Additional number(s) to call:

Mail to: WBG Volunteers - P.O. Box 1577, Williamsburg, VA 23187-1577 OR Scan your completed form and email to WBGvolunteers@

Volunteer Application, Waiver Agreement, Emergency Info - v: 05-23-2019

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