Volunteer WAIVER Form Johnson Creek Watershed Council- Prairie nesting bird survey- Powell Butte

Contact Details

First Name

Last Name

Mobile Phone

Home Phone

Zip Code

Are any other volunteers coming with you? Please fill out a separate form for each person coming, if so.

No, it's just me!There are others coming with me. If they are under 18 under my supervision, I will fill out another form for them. If they are over 18, I will invite them to sign this wavier by copying and pasting the URL for this form. Note: Minimum age to survey is 16 minors must be accompanied by legal guardian at all times

If you are under 18 and planning to come without a parent/guardian, you can't sign this form. Please have your parent/guardian sign for you, and make sure to have their phone number included in the box above. Our team will reach out to your parent/guardian to verify that they have given their permission for you to survey.

This is OK with me. I will have my parent/guardian sign.This is not OK with me. I will not survey.

Please note: Oregon Health Authority may use your information to contact you if someone who attends a survey tests positive for COVID-19. This only applies if you wish to go on a survey with people outside of your COVID-19 pod. We recommend people choose to create their survey team from people they already associate with.

My name below acknowledges that I have read this waiver and hereby agree:

In connection with my voluntary involvement in activities undertaken for, and with the participation and support of the Johnson Creek Watershed Council, a non-profit organization, Portland Parks & Recreation, Conservation InSight, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge the Johnson Creek Watershed Council, Portland Parks & Recreation, Conservation InSight and other project sponsors, their members, officers and directors, employees, agents, volunteers, sponsors and landowners from all claims, demands, and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from negligence, and I agree to release and hold the Johnson Creek Watershed Council, Portland Parks & Recreation, Conservation InSight and other project sponsors, their officers and directors, employees, agents volunteers, sponsors and landowners harmless from any cause of action, claim, or suit arising there from. I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and conditions of this release.
I hereby grant Johnson Creek Watershed Council, Portland Parks & Recreation, Conservation InSight the irrevocable right to use forever any film, video tape, audio tape, photographs, slides, or combination thereof, for inclusion in any promotional or advertising purposes and I agree to appear without pay. If I do not want to be photographed, I will inform staff and they will try to accommodate my wishes.
I hereby agree to use good judgment based on my physical ability and to immediately terminate my participation in the project if activities become too strenuous or difficult; I am physically and mentally fit and able to participate in this project.

Checking the box and typing my name below acknowledges that I have read this waiver and hereby agree.

I agree.

Waiver Signature (type full name)

Contact Information