Zero Waste Initiative Interest Form

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Full Name *

Email *

Phone # *

City you live in *

Grade and School, if applicable

Emergency Contact(If under 18, must be a parent or a guardian) Name and Phone *

I am healthy *

Yes

I have not been out of the country in the last 21 days *

Yes

I have been practicing social distancing, washing hands for 20 seconds or longer, and interacting only with those in my household as recommended by the state of California and other governmental authorities. *

Yes

Do you have a valid driver's license or can someone drive you? *

Yes

I pledge that by signing up as a volunteer for the Zero Waste Initiative, I will follow all safety protocols. *

I agree

If any of my household members or other close contacts begin to feel any symptoms of COVID-19, I will immediately notify the Zero Waste Initiative and quarantine myself for a 14 day period *

I agree

I (and, if under age 18, my parents or guardians) hereby release, indemnify, defend, and hold harmless the Zero Waste Initiative, its founder, board members, and other organizers, from and against any and all claims, causes of action, and liability arising from or in any way connected with my volunteer participation with the Zero Waste Initiative, including as the same may result of coming into contact with and/or the spread of COVID-19. *

I agree

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