Tallapoosa Day of Action

Day of Action Volunteer Registration

I would like to volunteer at:

Name

Cell Phone

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Date of Birth

Is the Volunteer 18 years old?

Yes

Emergency Contact Name

Emergency Contact Phone

T-shirt Size

If you would like a t-shirt, please check your size below. ALL sizes are ADULT sizes.

Small

Medium

Large

X-Large

Limitations

Please note below any health issues, physical limitaions, disabilities, conditions, etc. that may affect your service as a volunteer.

WAIVER & RELEASE

PLEASE READ EACH STATEMENT BELOW CAREFULLY AND ACKNOWLEDGE AS REQUESTED

WAIVER & RELEASE: The above named person desires to work as a volunteer for the Lake Martin Area United Way and is aware of the wide range of activities associated with volunteering for Day of Action and has made a voluntary choice to engage in these activities.

I agree with the Waiver and Release Statement

LIABILITY RELEASE: I, for myself and my heirs, executors, administrators and assigns, hereby release, indemnify nad hold harmless the Lake Martin Area United Way, local governments, State of Alabama, the organizers, sponsors, and supervisors of all activities from all liability for any and all risk of damage or bodily injury or death that may occur to me (including any injury caused by negligence), in connection with any volunteer effort in which I participate. I likewise hold harmless from liability any person(s) transporting me to or from any volunteer activity. I will abide by all safety instructions and information provided to me during my volunteer efforts.

Further, I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the State of Alabama, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I have no known physical or mental condition that would impair my capability to participate fully, as intended or expected of me.

I have carefully read the foregoing release and indemnification and understand the contents thereof and indicate as such below by my own free act.

I agree with the Release of Liability Statement

PHOTOGRAPHY RELEASE: Volunteer agrees to and permits the Lake Martin Area United Way and its designated representatives to take photographic inages and video and audio recordings of him/her during his/her work relating to the Day of Action. Volunteer also grants and conveys to United Way all rights, titles, and interests insaid photographic images and video and audio recordings, including, but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings. Volunteer further consents to and authorizes United Way to use and reproduce said photographic images, video and audio recordings and to circulate and publicize the same by all means, including but not limited to, newspapers and other print media, television media, brochures, pamphlets, marketing materials, social media sites, and websites.

I agree with the Photography Release Statement

Volunteer Signature

Sign above

Parent/Guardian Signature

Sign above if volunteer is under age 18

TALLAPOOSA COUNTY Day of Action 2025

Each year, United Ways across the country participate in a National Day of Service called Day of Action. It's the perfect opportunity to roll up our sleeves and let our actions speak louder than words.

Tallapoosa Day of Action

TALLAPOOSA COUNTY Day of Action 2025

Each year, United Ways across the country participate in a National Day of Service called Day of Action. It's the perfect opportunity to roll up our sleeves and let our actions speak louder than words.

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