Name
Street Address
Date of Birth (for background check)
Phone
Email
We perform yearly background checks on all volunteers: Have you ever been convicted of a crime? [If yes, please explain the nature of the crime and the date of the conviction and disposition.] Conviction of a crime is not an automatic disqualification for volunteer work.
Main Street Zephyrhills, Inc does not and shall not discriminate based on race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, selection of Board Members, volunteers, participants and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all of our staff, members, volunteers, subcontractors, vendors, and clients.
Participating officers, agents, volunteers, and employees of Main Street Zephyrhills release the rights to all images taken of participants to Main Street Zephyrhills Inc. Main Street Zephyrhills, Inc. may display, publish, alter, or reproduce the images acquired for any use, including but not limited to display through social media, news coverage, marketing material design and/or any application as determined by Main Street Zephyrhills, Inc.
Hold Harmless Agreement The undersigned agrees that they have read and understand the Rules and Regulations set forth for this event and agrees to comply as described. The undersigned also understands failure to comply will result in a direct order to vacate the event. Participate shall defend, indemnify and hold harmless Main Street Zephyrhills and The City of Zephyrhills and all of their officers, agents, volunteers, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorney’s fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of Participate, its officers, agents or employees in performance or non-performance of its obligations under the Agreement. Participate recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to Main Street Zephyrhills and the City of Zephyrhills when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by Main Street Zephyrhills and the City of Zephyrhills in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve Vendor of its liability and obligation to defend, hold harmless and indemnify Main Street Zephyrhills and the City of Zephyrhills as set forth in this article of the Agreement. By signing this application, I understand this disclaimer. I certify that I have fully read the above Rules and Regulations and agree to abide by all of the terms and conditions. I/we certify that individuals will not be barred from participation in the event due to race, creed, color, national origin, sex, age, or physical impairment.
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