BGC Battlefords 24th Annual Gala - Volunteer Form

BGC BATTLEFORDS 24th ANNUAL GALA -
VOLUNTEER FORM

BGC Battlefords 24th Annual Gala - Volunteer Form

VOLUNTEER INFORMATION

*Please note, this is an application form to become a volunteer for BGC Battlefords 24th Annual Gala.

Full Name *

Middle Initial *

Date of Birth (Month/Day/Year) *

Mailing Address *

Address Line 1

City

State / Province / Region

Postal Code

Physical Address (if different from mailing address):

Address Line 1

City

State / Province / Region

Postal Code

Primary Phone Number *

Email Address *

Would you like to be signed up for our monthly newsletter? *

Yes
No

Background Information (Voluntary): To support BGC Battlefords in tracking progress, statistics, and applying for funding. Please check if any of the below categories apply to you. *

Country of Origin *

Previous BGC Member: Were you ever a member or participant of any BGC Club as a child or youth? *

Yes
No

If yes, which club & what year were you last a member/participant?

EMERGENCY CONTACT

EMERGENCY CONTACT -Name *

First

Last

Primary Phone Number *

MEDIA CONSENT & RELEASE

BGC Battlefords has the right to use any artwork, photographs, video, and/or audio of you while participating in Club activities for the purpose of advertisement and promotional campaigns in the future. Your image may be published or used in newspapers, promotional videos, television commercials, television news items, program brochures, posters, social media sites, etc. or otherwise displayed to the public or used for other educational /fundraising purposes, either in whole or in part by BGC Battlefords, BGC Canada and/or external partners. No names will ever be used in association with your image without your written permission. *

Yes, I agree.
No, I do not agree.
Other

Please indicate any restrictions:

MEDIA CONSENT & RELEASE - Name *

First

Last

MEDIA CONSENT & RELEASE - Date *

Being a volunteer of BGC Battlefords 24th Annual Gala means that I understand my actions, behaviors and attitudes should align with the Club's Vision, Mission and Values while attending this event. I further agree to follow all rules and regulations as required during my volunteerism *

Yes, I agree.
No, I do not agree.

VOLUNTEER - Name *

First

Last

VOLUNTEER - Date *

WAIVER OF LIABILITY AND RISK

With full knowledge of the existence and nature of my legal right and in consideration for the opportunities provided to me by BGCB, I waive my legal right against BGCB, its staff, volunteers, or Board of Directors for any injury or damage suffered during or by reason of practicing, participating or assisting in a BGCB service, program, or experience.

WAIVER OF LIABILITY AND RISK - Name *

First

Last

WAIVER OF LIABILITY AND RISK - Date *