VOLUNTEER GUILD: Information, Registration and Informed Consent Form
The Claude Moore Colonial Farm is always seeking volunteers. Please fill out and submit the form below. PLEASE NOTE: It is each volunteer's responsibility to contact the Farm to set up date(s) to volunteer. Submitting the form below does NOT sign you up for a volunteer day; it provides the Farm with the information we need to have on file for each volunteer. Thank you!
Your Contact Information
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First Name
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Last Name
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Address 1
Address 2
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City
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State
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Postal Code
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Primary Phone
Secondary Phone
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Email Address
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Date of Birth
Participating Family Members (and ages, if under 18):
Emergency Medical Information
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Emergency Contact Name:
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Phone Number
Alternate Phone Number
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Are you restricted from performing any physical activities?
No
Yes
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Are you currently taking any medications?
No
Yes
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Date of last tetanus shot:
Volunteer Interests
What days of the week are you consistently available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What areas of work would you be interested in (check all that apply)?
Market Fair (costumed volunteering),
Market Fair (behind the scenes),
Costumed volunteering on our 1771 farm,
Gardening & Greenhouse,
Animal Maintenance,
Sorting Donated Books & Items,
Facilities (splitting wood, construction, repairs),
Sewing & Mending,
Retail,
Fund Raising,
Other
Comments/Additional Information
Informed Consent
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By typing in my full name I certify that I have read, understand and agree to the conditions in the Informed Consent located below:
I wish to volunteer my services to the Claude Moore Colonial Farm at Turkey Run, Inc (the Farm). I understand the nature of the volunteer activities that are to be performed by me may involve physical activity, contact with unidentified and unfamiliar persons, tools and equipment as well as farm animals and may involve other potential risks of injury.
Knowing this, I still wish to volunteer and hereby assume the risk, with respect to any liability of the Farm for such risks of any accident or injury to person or property, which I may sustain in connection with my participation as a Farm volunteer. In addition, I hereby release and discharge the Farm and all of its directors, officers, employees, partners, affiliates, agents or successors from any and all liability or responsibility for any such accident or injury. I have health insurance coverage, which would cover any accident or illness, and I understand that the Farm will not be responsible for any medical expenses, which I may incur as a result of my activities as a Farm volunteer.
Understanding that the Farm is an organization involved in providing educational programs to adults and children, I hereby affirm that I have never been convicted of a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I been ordered by a court to receive psychiatric or psycological treatment in connection therewith.
I understand that failure to cooperate with the Farm staff and abide by the rules and standards of the park will result in forfeiture of the right to participate as a Volunteer of the Farm. I recognize that children must remain with their parent/guardian or their supervising adults at all timeswhile on Farm property. I authorize the non-commercial use of any photographs, film, recording or video tape to publicize the Farm.
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Today's Date
If participating youth is under 18:
I concur that my child, who has signed above, may participate as a volunteer at the Farm in accordance with the Informed Consent located below this form on the website of the Claude Moore Colonial Farm www.1771.org and I waive any claim which I might have as a parent/guardian on behalf of such child against the Farm, its directors, officers, employees, partners, affiliates, agents or successors. NAME OF PARENT OR GUARDIAN:
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Indicates Response Required
Report Abuse
All volunteers must read this Informed Consent Section and sign the form in the section above.
A parent/guardian signature is required for any youth under the age of 18 years.
I wish to volunteer my services to The Claude Moore Colonial Farm at Turkey Run, Inc. (the Farm). I understand the nature of the volunteer activities that are to be performed by me may involve physical activity, contact with unidentified and unfamiliar persons, tools and equipment as well as farm animals and may involve other potential risks of injury.
Knowing this, I still wish to volunteer and hereby assume the risk, with respect to any liability of the Farm for such risks of any accident or injury to person or property, which I may sustain in connection with my participation as a Farm volunteer. In addition, I hereby release and discharge the Farm and all of its directors, officers, employees, partners, affiliates, agents or successors from any and all liability or responsibility for any such accident or injury. I have health insurance coverage, which would cover any accident or illness, and I understand that the Farm will not be responsible for any medical expenses, which I may incur as the result of my activities as a Farm volunteer.
Understanding that the Farm is an organization involved in providing educational programs to adults and children, I hereby affirm that I have never been convicted of a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I been ordered by a court to receive psychiatric or psychological treatment in connection therewith.
I understand that failure to cooperate with the Farm staff and abide by the rules and standards of the park will result in forfeiture of the right to participate as a Volunteer of the Farm. I recognize that children must remain with their parent/guardian or their supervising adults at all times while on Farm property. I authorize the non-commercial use of any photographs, film, recording or video tape to publicize the Farm.