Volunteer Registration

Saturday, September 24, 2011

Trentadue Winery, Sonoma County CA

Volunteer Registration: Volunteer registration is $25 per person.  Space is limited.

To register to volunteer, please fill out this form.  All fields are required.
All information is held in the strictest confidence.
Name:
First name:  
Last name:
Your contact info:
Phone:
E-mail:
Street Address:

City:
    
State:
  Zip:
Are you volunteering with a group?
Example: Larkin Street, BAADS, Special Olympics, etc.
 While we will do our best to assign you the task you have requested, we appreciate your flexibility in working with our needs.  We will contact you at least two weeks before the event with more information and with final volunteer assignments.

Please select your prefered task:
  Outrider or Tandem Captain. Only check this if you know who you are partnered with and enter their name here:
If you are interested in this role and do not have a partner, please do not check this box without first emailing moana@borp.org


Yes - I want to play a crucial part in this year's Revolution and volunteer. Assign me to where I am needed most!

Have you volunteered at Revolution before?  If so, what was your assignment?
Previous volunteer assignment (if any)
 
Do you require a vegetarian meal?
  Yes I require a vegetarian meal
  No I do not require a vegetarian meal
What is your T-Shirt size? *

(Women's S, M, L, XL Men's S, M, L, XL, XXL)
Comments?  Example: Do you have special abilities to contribute, or physical limitations that might limit your ability to do some volunteer tasks?
       

RELEASE OF LIABILITY - READ BEFORE SIGNING

In consideration of being allowed to participate in any way in the Bay Area Outreach and Recreation Program (BORP), its related events and activities, I, the undersigned, acknowledge, appreciate, and agree that:   

1.    The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2.    I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3.    I willingly agree to comply with the stated and customary terms and conditions for participation.  If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately: and,

4.    I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Bay Area Outreach & Recreation Program (BORP), their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.


MEDIA RELEASE

I hearby authorize and give my full consent to BORP to copyright and/or publish any and all photographs, videotapes, and/or film in which I appear while attending BORP events/activities. I further agree that BORP may transfer, or cause to be used these photographs, videotapes, or films for any exhibitions, public displays, publications, commercials, art and advertising purposes and television programs without limitations or reservations.
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Type your full name here if you are in agreement with the liability waiver (required):

Would you like to be on the BORP eNewsletter list?
Please verify that all information above is correct before you click below. Clicking below will connect you to payment options.

1. Pay by logging into your PayPal account

OR

2. Pay without a PayPal account
 • Note that you do NOT need a PayPal account to pay with a credit card. Simply enter your credit card info and your contact info, and payment should go through.

OR

3. Payment by Check
  Please note that your registration status will remain as "pending" until we receive your payment. If you wish to pay by check, please make your check payable to BORP and mail to:
   BORP: Revolution Ride
   Attn: Moana Newman
   3075 Adeline Street, Suite 155
   Berkeley, CA 94703-2545