RELEASE AGREEMENT: LAS TRAMPAS, SAN RAMON OR WALNUT CREEK CLEANUP

1. I have volunteered to participate in the Las Trampas, San Ramon or Walnut Creek Volunteer Clean-up. I understand the creek banks are steep, uneven, may have uncertain footing, and contain broken and discarded items, including broken glass, metal and possibly-hazardous substances, and that in participating in the project I expose myself to injury from these items and other causes.

2. In consideration for being allowed to participate in this Clean-up event, I do hereby waive and release any and all rights and claims or damages I may accrue against the persons owning the Creek, Friends of the Creeks, the Contra Costa County Flood Control District, the City of Walnut Creek, their officers, agents or employees, or any other person or organization affiliated with the Clean-up Event for any and all injuries that may be suffered by me arising out of my participation in this event.

3. I agree that my image may be used in any photographs and videos taken for publicity, historical or educational purposes.

Please print all fields
____________________ _____________________________    __________________________________
Date Volunteer 1 (You or your minor child)    Volunteer 2 (You or your minor child)

___________________________________________                    ___________________________________
SIGNATURE (Participant or Parent/Guardian if under 18)                  PRINT NAME of Parent/Guardian

____________________________        ________________________________________________________
City                                                            Email (optional)

EMERGENCY CONTACT INFORMATION (an adult who is not participating in this event):
 

________________________________             ___________________________                    ___________________________
Name                                                         Relation to volunteer(s)                           Phone (best to contact)


VOLUNTEERS UNDER 12 YEARS OF AGE SHALL BE ACCOMPANIED BY AN ADULT

______________________________________________________________________________________________________________________________