Volunteer Signup Form

*First Name:

*Last Name:

*Address:

Address 2:

*City:

*State:

*Zip/Postal Code:

*Home Phone:

Cell Phone:

*Email Address:

Fax (if available):

Emergency Contact (name & phone):

Name of group (if yes above):

Name of organization (if yes above):

Do you have special circumstances or conditions that we may need to know to place you in a volunteer position? If you do please explain below:

I, for myself as well as for my heirs, executors, administrators, trustees, and assigns, hereby waive and release any and all rights and claims for any fatality injuries and/or damages, including, but not limited to, demands or actions for negligence, premises liability, emotional injury, intentional conduct, tort claims, and any other actions or demands of whatsoever nature I have or may have in connection with my participation as a volunteer in the Canton Marathon against all sponsors of the Canton Marathon and otherwise agree to hold these entities harmless. I acknowledge that I am aware of the inherent risks (physical and otherwise) involved in volunteering for the event and I voluntarily assume these risks. I further attest and certify that I am physically capable of performing the tasks required for the volunteer job(s) I have selected.

*I Agree (initials):

*Date:

Parent or guardian approval required for minors.