Volunteer Name
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First Name
Last Name
Parent/Guardian Name
If you are the legal guardian registering a volunteer who is under 18 years of age, please enter your name.
First Name
Last Name
Previous Planting Experience
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Have you planted with us in the past?
Fruit Tree Experience
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Do you have experience with fruit tree care?
Orchard Team Preference
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I would like to be contacted to volunteer on the following team(s)
Volunteer Phone Number
Phone number is used to communicate weather-related delays or cancellations if/when email is not an option.
(###)
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Emergency Contact
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Please provide an emergency contact.
First Name
Last Name
Emergency Contact Phone Number
*
(###)
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Please select "yes" if you agree to the terms of the liability waiver for yourself or on behalf of an individual under the age of 18.
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I desire to participate as a volunteer with Dubuque Trees Forever to provide tree planting services, including but not limited to, digging holes, setting trees in the spot, backfilling, mulching and watering (hereinafter “Planting”), for the benefit of the City of Dubuque (hereinafter “DUBUQUE TREES FOREVER”). I represent, acknowledge, and agree that:
(A) I am entering into this Volunteer Release and Liability Waiver (the "Release") freely and voluntarily, without duress, for the benefit of the DUBUQUE TREES FOREVER and City, and their directors, officers, employees, agents, contractors, volunteers and constituent members, and their respective successors and assigns.
(B) My participation is strictly voluntary, and without compensation. In performing Planting, I am not an employee of DUBUQUE TREES FOREVER or City or any of their constituent members (irrespective of whether I may be an employee of any such party for other purposes), and I will not represent myself as such. I understand neither DUBUQUE TREES FOREVER or the City carries or maintains any health, medical, or disability insurance coverage, for volunteers, and that I am expected to carry my own personal health insurance.
(C) I am aware that Planting often involves hard physical labor, heavy lifting and other strenuous activity. I am in good health and physically able to perform this type of work. I am also aware that Planting will be conducted in environments that may be inherently dangerous or hazardous, and that this entails certain risks, including (but not limited to) accidents, bodily injury, illness or death, damage to property or other loss.
(D) My participation in Planting is entirely at my own risk, and I assume all risk and responsibility for any property loss or damage, bodily injury (including death), personal injury, or illness that I may sustain because of my participation, including related medical costs and expenses. To the fullest extent permitted by law, on behalf of myself, my successors and assigns, I release and forever waive, and hold DUBUQUE TREES FOREVER and City, their officers and employees harmless from, all claims, causes of action, liability and damages that I now or hereafter have with respect to any property loss or damage, bodily or personal injury, illness or death that may result from or arise in connection with my participation in Planting.
(E) I will always fully observe and abide by all Policies and Procedures established by DUBUQUE TREES FOREVER and City with respect to Planting. Any questions about the Policies and Procedures will be resolved by Laura Roussell of DUBUQUE TREES FOREVER, or her designee (DUBUQUE TREES FOREVER Designee), whose decision I will respect as final.
(F) In the event of any emergency, I authorize the provision of any first-aid or medical treatment deemed necessary for my immediate care from any licensed hospital or medical personnel, and I will be responsible to pay for all such services. I release and forever discharge DUBUQUE TREES FOREVER and City from liability for all claims arising on account of any such treatment or services.
(G) I have the right to discontinue participation in Planting at any time and for any reason, in my sole discretion. If I choose to do so, I will notify the DUBUQUE TREES FOREVER Designee of my decision as soon as possible. I understand that DUBUQUE TREES FOREVER and City have the right to terminate my Planting volunteer services at any time and for any reason, in their sole discretion. The DUBUQUE TREES FOREVER Designee has the authority to direct the entire team, or any individual member (including me) to leave a site at any time for any reason, and I will promptly comply with all such directions.
(H) DUBUQUE TREES FOREVER and City shall have the right to use, for any legitimate purpose, all photographic images and video or audio recordings provided to them of any Planting activities, including those in which I am depicted, and I waive all rights to compensation by reason of such use.
(I) I understand and acknowledge this Release shall remain in effect for one (1) year from the date of signature below unless I revoke it earlier in writing to both DUBUQUE TREES FOREVER and City.
Yes, for myself
Yes, on behalf of a minor for whom I am the legal guardian
No