Volunteer Waiver Form

We look forward to your participation in the Central Park Conservancy’s volunteer experience. In advance of your scheduled event, please complete and submit the 'Day in the Dirt Volunteer Program Release and Waiver of Liability' form below:

First Name*

Last Name*

Email Address*

Company Name*

Address Line 1*

Address Line 2

City*

State or Province*

Zip Code*

Phone Number*

Do you have any allergies or special needs?*

Yes

If yes, please explain:

Emergency Contact Name*

Emergency Contact Phone Number*

Emergency Contact Relationship*

I understand that I am voluntarily participating in a volunteer program conducted by the Central Park Conservancy, Inc. I am responsible for my own conduct, and will only perform work that I feel safe and comfortable doing. I will adhere to all instructions and safety guidelines communicated by Conservancy personnel at the volunteer work site.*

I understand that The Central Park Conservancy’s Day in the Dirt Program is conducted outdoors. Volunteer activities may include, but are not limited to, interacting with the public, walking over uneven terrain, working in inclement weather, raking, planting, weeding, spreading wood mulch, pruning, and the use of tools, including, without limitation, hand-held clippers, wheelbarrows, shovels, rakes, brooms, mulch forks, cultivators, and weed wrenches.*

I hereby release and agree to indemnify and hold harmless the City of New York, the NYC Department of Parks & Recreation, and the Central Park Conservancy, Inc., and their respective officers, directors, trustees, employees and volunteers from any liability, claims and causes of action arising out of or related to any loss, damage or injury to me or my property that I may sustain in connection with or arising out of this volunteer program.*

If I am injured while performing my assigned duties as a volunteer, I agree to notify my supervisor or Conservancy staff as soon as possible. In the event that I am injured, I hereby authorize and give my consent for medical care to be tendered in an emergency situation.*

I hereby authorize and give consent to the Central Park Conservancy to publish, reproduce, alter, copy or otherwise use photographs or videotape (collectively, "Images") in which I appear while enrolled as a participant in their program for any and all purposes, and without compensation provided to me. I waive and release any claims or actions against the Central Park Conservancy arising from the use of these Images.*

Acknowledge*

Yes, I want to stay up to date on Central Park

Interest

Park Features

Activities & Amenities

Area

Volunteer Waiver Form