General Volunteer Form Wildlands Network’s mission — to reconnect, restore, and rewild North America — can’t be accomplished without the help of our dedicated volunteers. Name * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Disclosure of Medical Conditions I understand that I am solely responsible for knowing my own physical condition and making my own decision about volunteering. I have disclosed all medications and conditions relevant to my participation to my supervisor or other staff at Wildlands Network. I understand that Wildlands Network needs such information because some medication side effects or medical conditions could affect my safety or that of other volunteers or employees of Wildlands Network. I consent to Wildlands Network sharing this information with volunteer leaders prior to the start of the project and health professionals or first responders should I become ill or injured while volunteering with Wildlands Network. Medical Care and Consent Waiver * I authorize Wildlands Network, its employees, and its partners to provide me with first aid and to arrange medical assistance, transportation, and emergency medical services for me if I get hurt while volunteering. I understand that I am solely responsible for any costs related to my medical treatment and transport, and that Wildlands Network does not provide health, medical, disability, or other insurance coverage for me. I agree Liability Waiver * I understand and accept that participation involves certain risks and hazards inherent to outdoor activities and carries the risk of injury, illness, or damage to personal property. I understand that I am required to comply with all rules, policies, and instructions provided by Wildlands Network staff and project leaders, including all safety guidelines and protocols. I understand that I am solely responsible for any injuries or harm to myself or my property that I may sustain while volunteering. With this knowledge, I forever release Wildlands Network and all entities involved in the project, and all their employees, volunteers, directors, officers, and representatives from any and all actions, claims or demands now and in the future for any injury, death or property damage related to my participation in these volunteer activities. I also agree that I, my assignees, heirs, distributers, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Releasee in connection with any matters covered by this release. I affirm that I have carefully read this agreement, understand its contents and am aware this is a release of liability. I agree Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Media Release I consent to having my photo and video taken and my likeness used in promotional, fundraising, educational, or other materials. If you would like to opt out, you may select the box below. Opt Out Thank you for volunteering! We look forward to seeing you in the field!