Volunteer Intake Form
*
Welcome to the volunteer network at the Georgetown Steam Plant. We're excited you're here. By filling out the following form we can identify the most productive volunteer opportunity for your time and skills.
First Name
Last Name
Email
*
Phone (Optional)
(###)
###
####
What areas of volunteer work are you most interested in? (Check all that apply)
*
(Check all that apply)
Educational Workshops
We are looking for folks to assist with SHTEAM (Science, History, Technology, Engineering, Art, Math) themed educational programming and workshops. If you would like to take the lead and facilitate an educational workshop please let us know your ideas here:
(Background Check Required)
What days of the week work best for you?
*
How many hours a week/month are you available?
*
What is your connection to the Steam Plant?
*
What excites you the most about joining our team?
What zip code do you live in?
*
THE GEORGETOWN STEAM PLANT COMMUNITY DEVELOPMENT AUTHORITY, SEATTLE CITY LIGHT ACCIDENT WAIVER AND RELEASE OF LIABILITY and COPYRIGHT RELEASE AGREEMENT
*
Volunteer Program
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, VOLUNTEERING IN THIS ACTIVITY OR EVENT, AND/OR VISITING THIS SITE FOR ANY OTHER PURPOSE WHATEVER, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the The Georgetown Steam Plant Community Development Authority(“GTSPCDA”), City of Seattle and Seattle City Light (“City Light”), from dangerous or defective equipment or property owned, maintained, or controlled by GTSPCDA or City Light, or because of their possible liability without fault. I acknowledge that this Accident Waiver and Release of Liability Form will be used by GTSPCDA and City Light and that it will govern my actions and responsibilities at said activity or event. In consideration of my participation in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to: liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, event and/or site visit; THE GEORGETOWN STEAM PLANT CDA and SEATTLE CITY LIGHT and/or their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, and/or activity or event volunteers;
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE The Georgetown Steam Plant CDA or Seattle City Light or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, event and/or site visit, whether caused by the negligence of release or otherwise. I acknowledge that GTSPCDA and Seattle City Light and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event, activity, and/or site visit on behalf of GTSPCDA or Seattle City Light.
(C) I hereby release to the GTSPCDA and City of Seattle and City Light, its agents, and employees all rights to exhibit photographs, videos, or any other media produced during the course of the above listed activity, event, or site visit in print and electronic form publicly or privately and to market copies in any way GTSPCDA or City Light deems appropriate. I understand that there will be no financial or other remuneration for recording me either for initial or subsequent uses of the media.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
Signature:
*
I acknowledge that I have read and agree to all the terms of the accident waiver and copyright release as detailed above:
First Name
Last Name
