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2. 
3. CITY OF NASSAU BAY PENINSULA CLEAN-UP

   Date: February 12, 2022

5. Event Sign-Up, Liability Release & Photo Authorization Form
   The Volunteer understands that he/she is engaging in activities that may expose him/her to dangers both from known risks and unanticipated risks. By signing this form the Volunteer discharges and holds harmless the City of Nassau Bay and Keep Nassau Bay Beautiful and its representatives from any and all liability, claims, losses, suits, damages, and demands of whatever kind or nature arising or resulting from property damage, bodily or personal injury and/or death that may be caused by Keep Nassau Bay Beautiful negligence or otherwise.
   
   By signing this form the Volunteer also understands that the City of Nassau Bay and Keep Nassau Bay Beautiful, its partners, and affiliates may use all photographic images, video or audio recordings, video or audio reproductions, films, radio or television broadcasts and any other reproductions of the activities without limitations. Permission is granted for use in any medium now known or hereafter developed, including printed media, video, still photography and the Internet.
7. Are You Signing Up for this Event as an Individual or Family / Household?

   1. Individual

   1. Family / Household

   Selecting Family / Household will allow you to sign up all volunteers at the same address on one form.
9. Name
11. Address
12. City
13. Zipcode
15. Email Address
17. Volunteer Under 18 Years Old?

    1. Yes

    1. No
18. Does Volunteer Need a Letter of Participation?

    1. Yes

    1. No
20. Name (Volunteer #1)
22. Address
23. City
24. Zipcode
26. Email Address
28. Volunteer #1 Under 18 Years Old?

    1. Yes

    1. No
29. Add Another Volunteer?

    1. Yes

    1. No
31. Does Volunteer Need a Letter of Participation?

    1. Yes

    1. No
33. Name (Volunteer #2)
35. Volunteer #2 Under 18 Years Old?

    1. Yes

    1. No
36. Add Another Volunteer?

    1. Yes

    1. No
38. Does Volunteer Need a Letter of Participation?

    1. Yes

    1. No
40. Name (Volunteer #3)
42. Volunteer #3 Under 18 Years Old?

    1. Yes

    1. No
43. Add Another Volunteer?

    1. Yes

    1. No
45. Does Volunteer Need a Letter of Participation?

    1. Yes

    1. No
47. Name (Volunteer #4)
49. Volunteer #4 Under 18 Years Old?

    1. Yes

    1. No
50. Add Another Volunteer?

    1. Yes

    1. No
52. Does Volunteer Need a Letter of Participation?

    1. Yes

    1. No
54. Please List the Remaining Volunteers Names and Ages
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field