Volunteer Attendance Form

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Email Address*

First Name*

Last Name*

If volunteering as a group, what is your group's name?

Reachable Phone Number

Child's Name (If required)

Amount of time Volunteering?*

What Task will you be helping with? Or what did you work on?*

I give the 4-H Education Center at Auerfarm permission to use my image in any marketing/social media posts*

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I, acknowledge that I am of lawful age and that I have volunteered to help at 4-H Education Center at Auerfarm, 158 Auer Farm Rd, Bloomfield CT 06002. I, acknowledge that I receive no compensation from Auerfarm. I acknowledge that this work will involve hard work, which may include bending, stooping, reaching, kneeling, lifting, using hand tools, using motorized tools, carrying and other physically challenging tasks, and I certify and agree that I am in good health and am physically able to perform such work. I acknowledge that my volunteer work may involve risk of injury from such work and I agree that I am helping Auerfarm at my own risk. I, agree that, while helping at Auerfarm, I will: * Observe all safety requirements of Auerfarm, where volunteer work is conducted, and * Use my best judgment and common sense to avoid injury or damage to myself, all other persons volunteering for Auerfarm, all persons on the premises where volunteer work is being conducted, all property. I, acknowledge that Auerfarm is allowing me to participate in this volunteer work in reliance upon the statements made in the Release and upon the release of possible claims that I am providing in the Release. Accordingly, I do hereby, for myself, heirs, executors and administrators, release, acquit, and forever discharge Auerfarm, and the property owners where the volunteer work is conducted and their respective heirs, executors, administrators, successors and assigns, of and from all, and all manner of actions, causes of actions, suit controversies, damages, judgments, and other liabilities, claims and demands of any nature whatsoever whether in law or equity, resulting from my volunteer services for Auerfarm I, understand that this release is intended to prevent any and all future legal action or claims which I might have against Auerfarm arising out of my involvement in volunteer work, including travel to and from the volunteer site. Thank you. We are thrilled to work with you.*

Yes No

We will never share your email address. Ever.

Submit Volunteer Attendance Sheet