Volunteer Registration Day of Caring Waiver Form Company / Group Name* Department* Team Name (if applicable) Name* First Last Company Title Email Address* Cell Phone*I am the team lead for this project Yes No This is my first DOC Yes No Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work PhoneLiability Disclaimer Agreement* I agree to the liability disclaimer agreement.In accordance with the spirit of volunteerism and service, I assume full and complete responsibility for any injury or accident that may occur to me during Day of Caring 2021, or while I am on the premises of any United Way of the Ozarks or Tri-Lakes Division (UWO) partner agency or other participating non-profit agency or school. I hereby release and hold harmless United Way of the Ozarks, United Way Tri-Lakes Division, United Way partner agencies, other participating non-profit agencies and schools, and all sponsors, persons, and entities associated with Day of Caring 2021 from liability for injuries and damages sustained to me, whether caused by negligence of the sponsors, other persons, or entities associated with this event, or otherwise. I also grant United Way of the Ozarks or United Way Tri-Lakes permission to use any photographs taken of me while I am working on the Day of Caring project, in conjunction with any of their publicity programs.T Shirt Size*SmallMediumLargeXL2XLEmailThis field is for validation purposes and should be left unchanged.
