Thank you for your interest in volunteering with GreenUP! GreenUP Volunteer Intake Form Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Your Current Age(Required) Under 16 (should be accompanied by an adult) 16 - 17 (requires written guardian permission) 18 - 35 36 - 49 50+ Your Current Age Do you know where at GreenUP you are interested in volunteering? Wherever you need me! Active Transportation Projects (i.e. Shifting Gears, Let's Bike, Cycling Counts) Administrative Roles Communications & Media Board of Directors Ecology Park Education Programs Green Economy Peterborough Peterborough Children's Water Festival Peterborough Community Orchard Stewards Neighbourhood Projects (i.e. Little Forests, DePave, Open Streets) Event or Workshop Please select all that apply.Your General Availability(Required) Weekdays - Working Hours (9am-4pm) Weekdays - Lunchtime (12pm-2pm) Weekdays - Evenings (after 4pm) Weekends - AM Weekends - PM Have you served as a volunteer at GreenUP in the past? Yes (thank you!) No If you have served as a GreenUP Volunteer in the past, which GreenUP staff did you have the most contact with?Emergency & Health InformationEmergency Contact Name(Required)Emergency Contact Phone Number(Required)Do you have any accessibility requirements that GreenUP staff should be aware of?Do you have any dietary restrictions that GreenUP ought to consider when hosting events at which we serve food?If yes, please list. If no, please leave blank.Do you have any allergies that may impact your volunteer role or that GreenUP ought to be aware of?If yes, please list. If no, please leave blank.GreenUP has a Conflict of Interest policy that applies to our volunteers. Are you aware of any conflict of interest you may have?(Required) Yes No Maybe If yes or maybe, we will be happy to review the policy with you and discuss how to best address the conflict.Release of LiabilityIn consideration of volunteering with GreenUP, I recognize and acknowledge that there are inherent risks and hazards involved. I freely and voluntarily agree to assume such risks, and hold harmless and indemnify GreenUP from any and all liability. I hereby waive any and all claims against GreenUP, including its staff, volunteers, directors, and agents arising out of my participation with the organization.(Required) Yes No I am under 18 and need a guardian to give my liability release Image ReleaseI hereby give GreenUP permission to use my name, photograph, video recording, audio recording, and/or likeness (collectively referred to as “My Image”) as they deem fit and appropriate to GreenUP’s purposes. I am aware and agree that My Image may be used in all forms including, but not limited to, media for broadcast or in printed publications, on GreenUP’s websites, in public displays, or in GreenUP publications. I am aware that GreenUP may share My Image with program partners and funders for their limited use, as it relates to a program or event. I waive any right to inspect or approve any publication of My Image by GreenUP.(Required) Yes No I am under 18 and need a guardian to give my image release Please provide contact information so that we can contact your parent or guardian regarding the above liability and/or image releases. We can contact them by email or phone.(Required)Upload a resume or CV if you'd like to share your skill set with us.Max. file size: 256 MB. Thank You!We appreciate your interest in volunteering at GreenUP!
