Volunteer Authorization and Photo/Video Release - Marion SWCD

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Volunteer Authorization and Photo/Video Release Form

Please check the following boxes

The undersigned hereby agrees:(Required)

to hold harmless, release and forever discharge Marion Soil and Water Conservation District, individual volunteers, project coordinators, sponsors, suppliers, supporters, landowners, and other organizations, their employees and agents, from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate may have by reason of this authorization.

to assume and accept responsibility for all risks arising from or relating to this project, that I am physically and mentally fit and able to participate in this project, and that participation in this activity is completely voluntary and that I have never received nor expect to receive any compensation for my participation;

(Required)

to read, listen to and follow all safety instructions presented in conjunction with this project and will use good judgment based on physical ability and to immediately terminate participation in the project if activities become too strenuous or difficult;

(Required)

to immediately report to a person in charge any injury to myself or another person or any accident that I may have caused or seen; and will report any equipment or tool that becomes unsafe or is damaged due to breakage or that was used improperly.

(Required)

to waive the right to inspect or approve the finished product, including written, audio or electronic copy, wherein my, or my minor child’s, likeness or voice appears, or artwork submitted. I also give permission to Marion SWCD to use my or my minor child’s grade level in school, college or university, name and school, college or university location as an accompaniment to the photo, video or voice recording, or artwork.

(Required)

to grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration.

(Required)

to waive any right to royalties or other compensation arising or related to the use of my image or recording.

(Required)

Materials will become the property of Marion Soil and Water Conservation District and will not be returned. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears for purposes of publicizing programs of Marion SWCD, or for any other lawful purpose.

(Required)

Photographs may be taken of people at this activity and may be used in written materials, the Marion SWCD newsletter, web page, social media or other publications. The Marion SWCD will not use or release any photograph of a person(s) or use or release any person’s name for use that is prohibited by law or without the person’s written permission and in the case of a minor, without parental consent.

(Required)

Photographic, audio or video recordings may be used for the following purposes: Promotional print materials Educational print materials Social media or internet posting

(Required)

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

Consent(Required)

By checking this box and typing my name I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for the above stated purposes.

Name(Required)

First Last

Date(Required)

Month

Day

Year

Phone(Required)

Email(Required)

Address(Required)

Street Address City State ZIP Code

If this release is obtained from person under the age of 19, then the name and consent of that person's parent or legal guardian is also required.

FIrst and Last Name

Parental Consent

Yes I consent to my child’s image/video to be used by the Marion SWCD for the above stated purposes.

Δ

Upcoming Events

First Friday: Emerald Ash Borer (EAB) Adaptive Management: Inventory, Planning, Prioritization

February 6th | 12:00 pm

Board of Directors Monthly Meeting

March 4th | 6:30 pm

Board of Directors Monthly Meeting

April 1st | 6:30 pm

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Marion Soil and Water Conservation District

408 N Third Avenue PO Box 537 Stayton, OR 97383

Phone: (503) 391-9927

Email: office@marionswcd.net

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