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Volunteer Registration Form

If you are interested in volunteering with Seattle Tilth, please fill out this application. Thank you!

To begin volunteering with Seattle Tilth, please fill out the form below and attend a                    Volunteer Orientation to get signed up for a position. If you are under 18 years of age,         please bring a signed Hold Harmless Form the first time you come to volunteer.

Questions? Contact emilygordon@seattletilth.org

* = required field

Title
Zip*
Employer or School

Interests

(hold CTRL to select multiple)

Program Preferences
Location Preferences

Availability

(hold CTRL to select multiple)

Educational Background
Why are you interested in volunteering with Seattle Tilth?
What do you hope to learn as a volunteer/intern?
How did you hear about Seattle Tilth and our volunteer opportunities?
 
Seattle Tilth performs Washington State Patrol Background Checks on all volunteers. (A match does not necessarily prevent you from volunteering) The following is required:
Date of Birth* mm/dd/yyyy
Gender*
 
Emergency Contact Information
Name*
Primary Phone*
Additional Phone
 
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Emergency Medical Treatment, Liability Release, Hold Harmless and Photo Release Agreement


Emergency Medical Treatment Agreement
In the event of a medical emergency, the undersigned authorizes Seattle Tilth and their designated agent to authorize such medical assistance as they determine to be necessary. The undersigned authorizes any licensed physician and/or medical facility to provide any medical/surgical care and/or hospitalization, including anesthetic, which they determine necessary or advisable, pending receipt of a specific consent from the undersigned.

Liability Release and Hold Harmless Agreement
I wish to participate as a volunteer at Seattle Tilth. I understand there may be some risk associated with this activity and I am participating at my own risk. I, individually, and/or parent or guardian of a volunteer, hereby release and hold harmless Seattle Tilth for accidents, damage, death, illness, or injury to me suffered during or in connection with my volunteer work with Seattle Tilth Association.

Photo Release
I grant to Seattle Tilth, and its successors and assigns, the right to use and publish my photograph, video or voice recordings, or likeness/appearance, with or without my name, on a perpetual basis in any medium or format, for the promotional and educational purposes of Seattle Tilth and the artist who recorded or created the foregoing on behalf of Seattle Tilth. I hereby release Seattle Tilth from all claims and demands that I may have, including without limitation those based on copyright, libel, slander, violation of privacy or publicity or similar
rights, arising out of or in connection with the exercise of the rights authorized hereunder.


I have reviewed my application and I attest that the information is accurate and complete to the best of my knowledge, and give my consent to Seattle Tilth for the above Emergency Medical Treatment, Liability Release, Hold Harmless, and Photo Release Statements:

** Please Check!

 
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