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Volunteering
Sample Event
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For questions about volunteering please email us at:
walk@alzoc.org
Walk4ALZ Volunteer Registration
First Name
*
Last Name
*
Email
*
Phone
*
Age
*
12-17
+18
No minor is allowed to participate in an Alzheimer's Orange County project or activity without a parent/guardian signed release form.
*
I understand this policy.
Will you need your hours to be signed off on for credit?
*
Yes
No
AlzOC does not provide volunteer hour sheets for you to receive credit. You must provide your own sheet to be signed either the morning of Walk4ALZ, by email the week prior for pick up at check in or after the event has concluded.
*
I understand this policy.
Do you have any physical limitations?
*
Yes
No
If yes, please explain below.
Have you ever volunteered with us?
*
Yes
No
I agree to grant to Alzheimer's Orange County and its authorized representatives permission to record photography and/or video, including but not limited to, digital recordings, audio recordings, film recordings and any other forms of documentation of my participation. I further agree that any or all of the material photographed may be used, in any form, as part of any future publications, brochures, or other printed materials, digital media, websites or social media programs used to promote Alzheimer's Orange County, and further that such use shall be without payment of fees, royalties, special credit or other compensation.
*
Yes, I agree
ASSUMPTION OF RISK, RELEASE AND PERMISSION Walk4ALZ® involves walking – activities which may include risks such as, but not limited to, falls, interaction with other participants, effects of weather, traffic and conditions of the road. In consideration of being allowed to participate in this event, I hereby expressly assume all risks, including bodily and personal injury, death, property loss or other damages of any kind arising in any way out of my attendance or participation in the Walk4ALZ® and related activities. It is my responsibility to dress appropriately. Although route maps, rest stops, refreshments, and other assistance may be made available during this event, I am solely responsible for my own health and safety. I represent that I am physically fit and able to attend or participate in this event. I hereby for myself, my heirs, executors and administrators, release, discharge and agree not to sue Alzheimer’s Orange County, their respective officers, directors, volunteers, employees, sponsors and agents, from any and all liability, claims, demands and causes of action whatsoever, arising out of my participation in or attendance at this event and related activities – whether resulting from the negligence of any of the above or from any other cause. I agree that my assumption of risk and release hereunder shall be as broad and inclusive as is permitted under applicable law. If any portion of this agreement is held invalid, the remainder shall continue in full force and effect. I grant full permission in perpetuity to the organizers of this event to use, re-use, publish and re-publish my name and image as a participant in the event in photographs, video or other recordings.
I have read, understand and agree to the above terms of this agreement*
*
Yes, I agree
Group Registration
If you are registering as part of a group, please fill out the information below.
Group Name
Group Contact Name (First and Last)
Group Contact Email
Group Contact Cell Phone
The following section below is required for those who have a minor child volunteering in the event.
PARENTAL CONSENT FORM AND RELEASE
If a volunteer is below the age of 18, parents must fill out the following below. Applications for volunteers under the age of 18 will not be accepted if the portion below has not been completed.
Type out the full name of the parent or guardian.
Parent or guardian phone number.
Parent or guardian email address.
Type Minor Child's Name Below
I, the Undersigned, am the parent or guardian of the above-named student and wish to allow my minor child to volunteer services to Alzheimer’s Orange County. I acknowledge and agree that the nature of the volunteer services which are typically performed by Alzheimer’s Orange County volunteers, and which may be performed by my child as an Alzheimer’s Orange County volunteer, may involve (a) physical activity, (b) contact with unidentified and unfamiliar persons, (c) travel to and from various unspecified locations, and (d) other potential risk of injury. Notwithstanding the preceding sentence, I willingly and freely agree to have my child volunteer and hereby assume any and all risk, and agree to release Alzheimer’s Orange County for all liability for such risk, including without limitation risk of any accident, injury, illness or death to person or property which my child may sustain, even if caused by the negligent or reckless conduct of an Alzheimer’s Orange County employee or volunteer, in connection with participation as an Alzheimer’s Orange County volunteer or in any Alzheimer’s Orange County related project or activity. I understand that my child will not receive any monetary compensation for the services contributed or be guaranteed any future position at Alzheimer’s Orange County. The Undersigned hereby grants to Alzheimer’s Orange County the unqualified and perpetual right to use, and consents to the use of, the name and likeness of the above-named child in connection with Alzheimer’s Orange County photographs, worldwide and in any and all media, including, by way of illustration, but not limitation, the display of still photographs, the inclusion on the World Wide Web and the preparation and dissemination of any advertising and promotional materials used to promote Alzheimer’s Orange County. The Undersigned gives permission for the above-named child to be given emergency medical treatment and/or transportation if necessary in the event of accident, injury or sudden illness while said minor is engaged in volunteer service to Alzheimer’s Orange County. The Undersigned agrees to accept all financial responsibility for any such medical treatment and transport. The Undersigned further acknowledges the following: I have read this release (or have had it read to me) and fully understand each and every one of the provisions in this release and I hereby voluntarily give my express consent and agree to abide by the terms of this release.
By checking the box below, I am acknowledging to and agree the written statements above.
Yes, I agree
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