FOCHT Waiver
TOWNSHIP OF LOWER MERION
Department of Parks & Recreation
VOLUNTEER APPLICATION and WAIVER for Cynwyd Heritage Trail
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Email *
Volunteer name (last name first please)
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Age *
Address (street, city, state) *
Zip code *
Telephone number
Emergency contact/phone number
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Medical conditions/allergies/medications
Physicians name/phone number
LIABILITY WAIVER AND RELEASE                                           
I the undersigned, intending to be legally bound hereby, being the participant or the parent or legal guardian of the participant if under age 18, in consideration for permission to participate in this program sponsored by the Friends of the Cynwyd Heritage Trail and/or the Township of Lower Merion (the”Program”), recognize that the Program includes exposure to natural and manmade hazards including without limitation rosebushes, trees, ticks, poison ivy, cold weather, mud, animals pathways etc. Recognizing these hazards of the outdoors, I (we) hereby release the Township of Lower Merion, its officers, agents, employees, sponsors, organizers and leaders, and the Friends of the Cynwyd Heritage Trail, its board members, agents, contractors and volunteers from any and all actions, causes of actions, claims or any other liabilities whatsoever for any damage and/or injury to any person or thing in connection with the above activity. I authorize the above-named persons and/or entities to publish any photograph or likeness of the participant for any Trail-related activities. Furthermore, I hereby agree to refrain from bringing suit against any of the above named persons or entities on my own behalf and on behalf of the minor child participant as a result of any damage or injuries to any person or thing that occurs in connection with the above activity.            

Name entered below indicates signature of participant or participant's guardian, if under 18.*
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