Volunteers needed for plantings

I'd like to register for the following 2025 Native Pollinator Planting Events: *

November 18 (Tues) - 10:00AM - Noon

November 19 (Wed) - 10:00AM - Noon

December 2 (Tues) - 10:00AM - Noon

Name *

For liability purposes, please fill out a separate registration form for each person that will be attending. Thank you!

First Name

Last Name

Phone *

(###)

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Emergency Contact Name *

If participant is under 18, please include the name of a parent or legal guardian.

First Name

Last Name

Emergency Contact Phone Number

(###)

###

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Release of Liability *

By checking the box below, I agree to indemnify and hold the landowners, Clallam Conservation District and Clallam County Noxious Weed Control, their employees, their elected and appointed officials, any other third party involved with the event, and other event participants harmless from and against any liability, claim, injury, or costs arising from or resulting from my work as a volunteer and/or attendance at an education event. Furthermore, I acknowledge there are potential hazards associated with volunteer activities and/or participation at educational events and I agree to exercise common sense and follow all safety precautions to avoid accident and injury. I will contact the project leader(s) in case of an accident or if I observe safety hazards or violations.

I acknowledge I have read and agree to Clallam Conservation District’s Release of Liability as presented above.

Health Guidelines *

If indicating any of the following symptoms I will not attend the event: Fever, chills, cough, shortness of breath, fatigue, muscle pain, headache, loss of taste or smell, sore throat, stuffy or runny nose, nausea, vomiting, diarrhea.

I acknowledge that I have read and agree to Clallam Conservation District’s Health Guidelines as presented above.

Photo Release *

I give my permission to have my photo or my child’s photo taken during this event and used for publicity purposes for hosts or sponsors.

Yes

No