Trail Crew 1523 Registration Form Trail Crew Registration, Crew 1523, Miners Creek II, August 17-20 "*" indicates required fields Step 1 of 4 25% Please read these guidelines carefully: Age: Volunteers must be at least 18 years old at the time of crew to participate. Those under 18 may participate if they have successfully completed a previous CTF crew or are accompanied by a guardian for the entire term of the crew.Waiver: This is a multi-page form, including pages for waiver and parent/guardian info for those under 18. Confirmation & Deposit Refund Policy: Your registration will be confirmed by email within 10 days. Crews are filled in the order that complete registration + waiver + deposit are received. Once registration is confirmed, deposit becomes non-refundable until successful completion of the crew. Gifts: All volunteers receive one gift for each trail crew they participate in, with a maximum of 1 gift of each type per season. Gifts will be delivered by Crew Leader on the first day of a crew. Participant Name* First Last Trail Name (if you have one) Crew Deposit*A $50 deposit per trail crew will be held for each crew member. Upon successful completion of a crew, your deposit will be automatically refunded or it can be donated to support CTF's trail crews. (Crew Leaders and Crew Chefs are not required to make a deposit, but there is an option to do so below if you'd like to use this function to make a deposit to support CTF's trail crews.) Crew Member ($50) CTF Authorized Crew Leader (no deposit required) CTF Authorized Crew Chef (no deposit required) Official Crew Leader or Chef, but I'd still like to make a donation ($50) Deposit Refund Option*After the completion of your trail crew, you have the option to have your deposit automatically refunded or to donate that deposit to CTF to support our trail crew efforts. Please select which option you prefer below: Please refund my deposit after the trail crew Please consider my deposit a donation to support CTF's trail crew efforts Participant Contact InfoAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone - Cell*Please provide your phone number, preferably a cell number so that you can receive text updates when your crew date arrives.Email* Birthdate (please use format MM/DD/YYYY, example 01/01/1970)* Gender* Male Female Prefer Not to Answer Emergency Contact InfoPlease provide information on who to contact in case of emergency.Emergency Contact Name* First Last Emergency Contact Relationship to Participant* Emergency Contact Phone*Volunteer Gift Selection*Each volunteer gets to pick one gift per trail crew as our way of thanking you for supporting our mission. Please select your gift below. (Please note, each volunteer is allowed a maximum one of each item per trail season, so if you're registered for more than one trail crew, be sure to select a different gift for each one.) Volunteer T-Shirt (Unisex) CTF Bandana CTF Insulated Grocery Bag No gift for me, but thank you! I've registered for more than 3 crews and have already selected my gifts! T-shirt Size*These are unisex t-shirts. For women, we suggest ordering one size down from normal. (Please select carefully, we will not be able to trade out sizes later) X-Small Small Medium Large X-Large XX-Large TransportationDo you need transportation assistance?* Yes No Can you help others with transportation to the meeting site?* Yes No Can you provide 4WD if needed?* Yes No General CommentsParticipant's past trail crew experience, if any*Comments, Notes, Questions Waiver and Liability Release AgreementWaiver and Release*As a participant in activities of The Colorado Trail Foundation, I agree to the following waiver and release: I acknowledge that backcountry travel, activities and work projects have risks, hazards and dangers that cannot be eliminated, particularly in a wilderness environment in mountainous terrain. I understand that these risks, hazards, and dangers, which may cause disability, injury and death, include without limitation: • Risks from activities in areas where no outside services are available or provided; where rescue and medical services are limited and slow, if available at all; where trail or road conditions vary, are not maintained, and are unpredictable and changeable; where weather also is unpredictable and changeable; and where injuries could include, but are not limited to, cuts, wounds, contusions, broken bones, sprained muscles, animal or insect bites/stings, exposure, dehydration, hypothermia, frostbite, and head injuries; • Risks involved in decision-making and route-finding in a wilderness environment; getting lost resulting in dehydration, hypothermia, or frostbite, • Other risks, hazards, and dangers common to wilderness travel and outdoor activities that include, but are not limited to, trail construction and repair, camping, cooking, hiking, climbing, mountaineering, and backpacking. I have read and understand the information provided by The Colorado Trail Foundation about the activities, work projects, and travel to and from such activities. I also understand that I have a responsibility for my own safety and the safety of others as a backcountry user. I understand and accept the risks described above.Assumption of Liability*I understand that participation in the travel, activities and projects of The Colorado Trail Foundation require good physical condition. I and/or my family, including my minor children, who are fully capable of participating in The Colorado Trail Foundation activities and willingly assume the risk of injury as my/our responsibility, including the loss of control or balance in walking, hiking, or climbing; weather; collision with trees, rocks, or other obstacles, whether obvious or not obvious. I am voluntarily participating in activities and projects of The Colorado Trail Foundation with full knowledge of the risks, hazards and dangers involved. I take responsibility for any injuries to myself.Indemnification and Model Release*By my signature, for myself, my family (including minor children), my estate, and my heirs, I hereby knowingly and intentionally release, indemnify and hold harmless The Colorado Trail Foundation, its directors, officers, service providers, independent contractors, agents, employees, and volunteers from and against any and all claims, actions, causes of actions, liabilities, suits, expenses (including attorneys’ fees) and negligence of any kind or nature, whether foreseen or unforeseen, arising directly or indirectly out of any damage, loss, injury, disability, or death to me or my property as a result of my participation in the activities and projects of The Colorado Trail Foundation, the use of its information or services and traveling in a wilderness environment in mountainous terrain, whether such damage, loss, injury, disability, or death results from negligence of The Colorado Trail Foundation, its directors, officers, service providers, independent contractors, agents, employees, or volunteers or from some other cause. I further agree not to sue The Colorado Trail Foundation, its directors, officers, service providers, independent contractors, agents, employees, and volunteers as a result of any damage, loss, injury, disability, or death that may occur while participating in its activities or projects. Also, I authorize the CTF, and or parties designated by CTF, to use my or my child’s photo for sale or reproduction in any manner CTF desires, for advertising, display, audio visual, or other use. I indemnify and release The Colorado Trail Foundation as specified above.USFS VOLUNTEER SERVICE AGREEMENT-Natural & Cultural Resources*All volunteers that participate with an organized group on an episodic volunteer project with a federal land and water management agency must be signed up on this form (unless otherwise signed up under an individual Volunteer Service Agreement, OF-301a). Volunteers under age 18 may not use this form, and must complete an individual Volunteer Service Agreement (OF-301a). This form must accompany a group Volunteer Service Agreement (OF-30la), completed by the group leader. Group leaders are responsible for ensuring every individual signed up on this form understand the duties to be performed and the terms of the project. (AGREEMENT # 22-GV-11020904-0002) I understand the health and physical condition requirements for this position, and I know of no medical condition or physical limitation that may adversely affect my ability to provide this service. I consent to being photographed, and to the release of my photographic image. Burden Statement: Completing this form is voluntary, but failure to provide the information will prevent program participation. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 1093-0006. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The U.S. Department of the Interior (USDOI), U.S. Department of Agriculture (USDA), U.S. Department of Defense (USDOD), and U.S. Department of Commerce (USDOC) are equal opportunity providers and employers and prohibit discrimination in all programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means of communication of program information should contact the volunteer program to which they are applying. If you would like to file a Section 508-related complaint, please contact the DOI Section 508 Program via email HaYt PERLINK "mailto:email@example.com" firstname.lastname@example.org or phone (202) 208-1530. Privacy Act Statement: Collection and use is covered by Privacy Act System of Records INTERIOR/DOI–05 Interior Volunteer Services File System (which may be viewed at https://www.doi.gov/privacy/doi-notices) and OPM/GOVT–1 General Personnel Records (which may be viewed at https://www.opm.gov/information-management/privacy-policy/#url=SORNs) and is consistent with the provisions of 5 USC 552a (Privacy Act of 1974), which authorizes acceptance of the information requested on this form. The information is used to identify persons interested in participating in a government volunteer program, managing the volunteer program, including tort claims and injury compensation. Records or information contained in this system may be disclosed outside the agencies participating in this program as a routine use pursuant to 5 U.S.C. 552a(b) (3. Completing this form is voluntary, but failure to provide the information will prevent program participation.. I have read, understand, and agree with the USFS Volunteer Service AgreementParticipant SignatureType Your Name Below to Serve as Your Digital Signature I am over 18 years of age.*Volunteers must be at least 18 years old at the time of crew to participate. Those under 18 may participate if they have successfully completed a previous CTF crew or are accompanied by a guardian for the entire term of the crew. Yes No Indemnification Agreement for Participants Under 18 Years of AgeName of Parent or Guardian* First Last Address or Parent or Guardian* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent or Guardian Indemnification*For the minor named above who will participate in activities of The Colorado Trail Foundation in mountain regions of Colorado, I agree to the following waiver, release and indemnification: The undersigned parent or guardian of said minor, for themselves and on behalf of said minor, joins in and agrees to the provisions of the “Liability Release Agreement” and hereby stipulates and agrees to save harmless, indemnify, and forever defend The Colorado Trail Foundation, its directors, officers, service providers, independent contractors, agents and employees, from and against any claims, actions, demands, expenses, liabilities (including attorneys’ fees) and negligence made or brought by said minor or by anyone on behalf of said minor, as a result of said minor’s participation in travel, activities and projects of The Colorado Trail Foundation, including the result of said minor’s participation in the travel, activities and projects of The Colorado Trail Foundation, including without limitation, his or her use of property and facilities of The Colorado Trail Foundation, his or her participation in specific activities of The Colorado Trail Foundation, or his or her travel to and from the site of such activities. I indemnify The Colorado Trail Foundation as specified above.Guardian SignatureType Your Name Below to Serve as Your Digital Signature PaymentTotal Deposit Due How do you want to pay?* PayPal Credit Card Click Submit below to enter your deposit payment on the next screen. Your payment will be processed as a donation and refunded after your trail crew, if requested.