Volunteer & Intern Registration

In the event of a medical emergency, the undersigned authorizes Tilth Alliance and their designated agent to authorize such medical assistance as they determine to be necessary. The undersigned authorizes any licensed physician and/or medical facility to provide any medical/surgical care and/or hospitalization, including anesthetic, which they determine necessary or advisable, pending receipt of a specific consent from the undersigned.

I wish to participate as a volunteer at Tilth Alliance. I understand there may be some risk associated with this activity and I am participating at my own risk. I, individually, and/or parent or guardian of a volunteer, hereby release and hold harmless Tilth Alliance for accidents, damage, death, illness, or injury to me suffered during or in connection with my volunteer work with Tilth Alliance.

I give consent for Tilth Alliance to take and use photos of me participating in Tilth Alliance programs or events.
Due to the phenomenal work volunteers do, we sometimes use images from sessions on our social media/e-news, in print, or for educational resources. To volunteer without agreeing to our photo release, please contact volunteer@tilthalliance.org.

I have reviewed my application and I attest that the information is accurate and complete to the best of my knowledge, and give my consent to Tilth Alliance for the above Emergency Medical Treatment, Liability Release, Hold Harmless, and Photo Release Statements.