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Virginia Aquarium & Marine Science Center

Aquavols@VirginiaAquarium.com

717 General Booth Boulevard Virginia Beach, VA 23451

Phone: 757.385.0274 Fax: 757.385.0228

Virginia Aquarium & Marine Science Center One-Day Volunteer Events Registration Form

Volunteer Information

Name

Address

Adult or Minor

Event

Creek Cleanup

Clean by Kayak (If you choose to clean by kayak, you must bring your own.)

E-Cycle

Emergency Information

General Volunteer Hold Harmless Information

VOLUNTEER STATUS/INSURANCE: I understand and acknowledge that while participating as a City Volunteer, I am not an employee of the City of Virginia Beach. I am not entitled to any employee or other benefits from the City of Virginia Beach such as health or accident insurance, workers’ compensation benefits, or compensation. I understand it is my responsibility, if desired, to provide my own health, disability, liability or accident insurance to cover my claims or damages from any injury, illness, death or property damage I suffer while performing volunteer work for the City of Virginia Beach. 

ASSUMPTION OF RISK: I am aware that participating as a volunteer in the City of Virginia Beach may involve certain risks, dangers, and hazards, including, but not limited to, possible injury, infection or loss of life in certain assignments such as those that involved the use of lawn care equipment, picking up dangerous debris (e.g., broken glass, needles, metal objects), working in roadways and disturbing bees, wasps, snakes, or other potentially dangerous animals. I freely accept and fully understand and assume all risks and dangers on my behalf or on the behalf of my minor child that may arise out of or result from participating as a City Volunteer. 

 

CONFIDENTIALITY AGREEMENT: As a volunteer of this organization, I understand that I may have access to confidential information, both verbal and written. I understand the City Department I volunteer with will advise me what information is confidential and understand, and agree, that all such information identified to me as confidential is to be treated confidentially and discussed only within the boundaries of my volunteer position at this organization. I also agree not to discuss these same matters after I have terminated my participation as a City Volunteer. 

RELEASE

General Volunteer Model Release Form

1. I hereby give my consent to the photographing and use of photographs of myself by the City of Virginia Beach and/or VirginiaAquarium & Marine Science Center for the sole purpose of publicizing or promoting the City of Virginia Beach and VirginiaAquarium & Marine Science Center. I understand photographs of myself and my likeness may be placed on posters; recruitmentmaterial; websites such as but not limited to VBgov.com, LinkedIn, Facebook, Twitter, YouTube; news publications; otherpublications; education materials; and advertisements in various media outlets. I understand that further release for any otherpurpose, unless required by the Virginia Freedom of Information Act, would require my signing a separate consent.

2. I hereby give my consent to audio and/or video taping of myself to be made by the City of Virginia Beach and the VirginiaAquarium& Marine Science Center for the sole purpose of publicizing or promoting the City of Virginia Beach and/or the VirginiaAquarium & Marine Science Center. I understand videos with audio of myself, my likeness and/or my name may be published onwebsites such as VBgov.com, Virginia Aquarium.com, LinkedIn, Facebook, Twitter, YouTube, VBTV; media sources; multimediaproductions; education materials; and advertisements in various media outlets. I understand that use of such audio or video tape for any other purpose would require my signing a separate authorization.

3. I understand that I will receive no compensation for the use of these photographs, audio and/or video tapes.

4. I understand that the City may provide others with copies of materials that include images of me, my likeness and my name, inaccordance with the provisions and requirements of the Virginia Freedom of Information Act or requests from the media in regardto the promotion of the City of Virginia Beach and/or Virginia Aquarium & Marine Science Center.

5. I understand that I have the right to withdraw this consent at any time, but that any photographs, audio and/or video that have already been taken and have been published and disseminated in accordance with the recruitment and rebranding campaign maycontinue to be used in that manner and circulated to the public.

Consent

Minor Date of Birth

Release

Email Opt In

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Individual or Parent/Legal Guardian Signature

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