Volunteer Registration Form

Volunteering for:     Individual    Two People    Organization or Group
Contact First Name:		Last Name:
Organization or Group:			Size of Group:
Address:
City:		State:	Zip:
Email:		Day Phone:
Evening Phone:		Cell Phone:
Best Way to Contact?	Email  Phone
T-Shirt Size?	Small  Medium Large  X-Large  XX-Large
2nd Person First:		Last:
T-Shirt Size?	Small  Medium Large  X-Large  XX-Large
T-Shirts: (enter quantities)	Small: Medium: Large: X-Large: XX-Large:
Note / Special Request:

 

I'm interested in the following volunteer positions .  .  . We are interested in the following volunteer positions .  .  . We are interested in the following volunteer positions .  .  .

Select your desired dates and times from the selection boxes below.  Press "CTRL Click" to select more than one position from each selection box.

Thursday, February 16th, 2012

3:30 pm - 7:00 pm - Registration and Packet Pick Up

Friday, February 17th, 2012 - Registration and Packet Pick Up

9:30 am - 1:30 pm - Registration and Packet Pick Up 1:30 pm - 6:00 pm - Registration and Packet Pick Up

Saturday, February 18th, 2012 - Race Expo

7:30 am - 12:30 pm - Race Expo 12:30 pm - 5:30 pm - Race Expo

Sunday, February 19th, 2012

5:00 - 8:00 am - Registration - Prospector Park 6:00 am - Noon - Drop bags 6:30 - 8:00 am - Food Preparation - Prospector Park 7:00 am - 2:00 pm -- Course Direction -- Various Locations 7:30 am - 2:00 pm - Finish Line 8:00 - 11:00 am - Food Distribution-Prospector Park 11:00 am - 2:00pm - Food Distribution-Prospector Park

WAIVER

In consideration of the foregoing, I, for myself, my heirs, my executor, my administrators, and my trustees, waive and release any and all rights and claims for any injuries and 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 against 1) the Lost Dutchman Marathon, its employees, principals, directors, shareholders, agents, and representatives 2) the city of Apache Junction, its departments, employees officials, agents, and representatives, 3) all sponsors of any Lost Dutchman Marathon events in which may participate as a volunteer.

I acknowledge that I am aware that there are risks involved in these events and I voluntarily assume these risks.

Further, I hereby grant full permission of any and all of the foregoing to use my name, my voice, and/or my picture in any broadcast, telecast, advertising, promotion, or other account of this event for any purposes whatsoever.

I agree to the above waiver