Church of Jesus Christ of Latter Day Saints Cleanup Saturday, May 4, 2019 9:00 AM 12:00 PM 09:00 12:00 US Army Corps of Engineers Visitor Assistance Center 2080 Jordan Dam Road Moncure, NC, 27559 United States (map) Google Calendar ICS 100 volunteers are expected. They will tackle trash along 2 mi. stretch of Kirks Creek adjacent to Jordan Dam Rd. Learn more about our group cleanup events here. REGISTER NOW CJCLDS Registration Form Your Agreement to Terms * CLEAN JORDAN LAKE (CJL) on condition of your signing this waiver and affirming the promises and statements contained below, agrees to permit you to participate in volunteer service with CJL Entering my information in the form below indicates I acknowledge the following to be true: I acknowledge that my services are provided strictly on a volunteer basis, without any pay or compensation of any kind, and without any liability of any nature on behalf of the CJL; all services are performed at my own risk. I acknowledge that my participation in volunteering with activities involved in the Project entails known and unanticipated risks that could result in physical or emotional injury, damage to me, to my property, or to third parties. These risks include the following but not limited to: Tripping, falling, scraping, bruising, scratched, bitten by insect or other, such as sunburn, poison ivy, etc. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. On behalf of myself, my heirs, personal representatives and executors, I hereby disclaim, release and waive any and all claims against the CJL for personal injuries or damages to property sustained by myself or any other person arising out of my participation in the PROJECT, including claims and damages arising in whole or in part from the negligence of CJL or its agents. IT IS MY EXPRESS INTENT TO RELEASE THE CJL FROM ANY AND ALL CLAIMS ARISING FROM MY PARTICIPATION IN THE PROJECT REGARDLESS OF WHETHER SUCH CLAIMS ARE FOUNDED IN WHOLE OR IN PART UPON ALLEGED NEGLIGENCE OF CJL OR ITS AGENTS. I agree to these terms and conditions. Please Enter Your Name * Please Enter Your Name In signing this release and waiver I am relying wholly upon my own judgment, belief and knowledge. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation as a volunteer, I may be found by a court of law to have waived my right to maintain a lawsuit against the CJL on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I read and understand it, and I agree to be bound by its terms. Enter your name below to indicate consent. First Name Last Name Photo Release * I hereby consent to and authorize the CJL, its publishers, licensees and assignees, permission to use and reproduce still photographs and/or film footage taken of me (and/or photos taken of my child/children) in whole or in part, with or without names, for editorial, trade or advertising purposes. I also confirm that I waive all claims arising from such use for any additional compensation, damages, and invasion of privacy. Enter your initials below to indicate consent. Would you like to receive our email newsletter? Yes No Your Email Address * Today's Date * Today's Date MM DD YYYY Your Address * Your Address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Name * Emergency Contact Phone * Emergency Contact Phone (###) ### #### Thank you! Your information has been delivered to the team at Clean Jordan Lake. We will be in touch soon.