BioBlitz @ Vincent DiFilippo Nature Preserve

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Email *

Adults first and last name *

Ages of youth

Interested in studying: (Check all that you want to study) *

8-10 a.m. Birding (Ornothology)

9a.m. Plant and Tree ID walk

9:45 a.m. Stream Buffer Maintenance Talk

9:30a.m. Retiles and Amphibians

10:30 a.m. Macroinvertebrates

11:30p.m. Fish and Boat (ID what is in our water)

1:30 p.m. Reptiles and Amphibians

All of the Above

Required

Photo and Media Release Form: By registering to attend the BioBlitz, sponsored by Conodoquinet Creek Watershed Association, CCWA, I grant permission to CCWA to take and use your photos in marketing and promotional pieces for an indefinite period of time. Marketing and promotional pieces include, but are not limited to, printed brochures, reports, postcards, flyers, and materials, as well as online uses such as postings on the CCWA website, online newsletters, and e-mail blasts. CCWA shall own all rights, including copyrights in and to the photos. You also grant permission to CCWA to use, encode, digitize, transmit, and display the video/audio of all programs you attend. During, singularly or in conjunction with other recordings, as well as to use your photograph, biographic information, and ancillary material in connection with such video/audio for commercial, promotional, advertising, and other business purposes. CCWA, volunteers, and its employees are released from any liability arising out of the use of your video, photographs, and/or organization name and location.If you do not agree to the photo release, you must provide CCWA with a picture of your child to cross reference all potentially used photos and video for marketing and promotional uses. *

I, the parent, have read and have read the photo release form and I agree to it.

I, the parent, have read and have read the photo release form and I do NOT agree to it and will provide TLC with a photo of my child.

Liability Waver *

By Registering for Conodoguinet Creek Watershed Association, CCWA, BioBlitz I am voluntarily enrolling my youth in the activities and will be present and liable for my child.

I knowingly and freely assume all risks, both known and unknown, and assume full responsibility for my participation and the participation of my minor children, in this program at Vincent DiFilippo Nature Preserve June 5th, 6 a.m. - 3 p.m.

I hereby hold CCWA, and its volunteers, employees, officers, agents, representatives, and organizers, harmless and indemnify any and all liability, actions, causes of action, fees, debts, claims and demands of every kind and nature whatsoever, whether for bodily injury, property damage or any other loss, which may arise from my participation, or my minor children’s participation, in all program and related activities. I certify that I enter into this activity voluntarily, and take full responsibility to participate or not to participate.

Send me a copy of my responses.

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