2024 Walk to End Alzheimer's Volunteer Interest Form for Greater Cincinnati Chapter
Please fill out this form Event Day Volunteer
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Email *
First Name *
Last Name *
Cell Phone Number (xxx-xxx-xxxx) *
Mailing Address *
City *
State *
Zip *
If you are volunteering with a group, please note the group name here. 
If you are volunteering with another person (friend/family) and wish to be together please note their name(s) here. 
Which Walk(s) will you volunteer for?  Check all that apply. *
Required
Requested Duty (please chose two) *
Required
If other, please note below
Have you volunteered at an ALZ Walk previously? *
Past Volunteer Role(s) *
Required
T-shirt size (all volunteers are required to wear a white volunteer shirt that will be provided to you on Walk day) *
Assumption of Risk, Release and Permission  Walk to End Alzheimer’s® involves walking-an activity which may include risks such as, but not limited to, falls, interaction with other participants , effects of weather, traffic and conditions of the road. In consideration of being allowed to participate in this event, I hereby expressly assume all risks, including bodily and personal injury, death, property loss or other damages of any kind arising in any way out of my attendance or participation in the Walk to End Alzheimer’s and related activities. It is my responsibility to dress appropriately. Although route maps, rest stops, refreshments and other assistance may be available during this event, I am solely responsible for my own health and safety.  I represent that I am physically fit and able to attend or participate in this event. I hereby for myself, my heirs, executors and administrators, release discharge and agree not to sue Alzheimer’s Association, its chapters, their respective officers, directors, volunteers, employees, sponsors and agents, from any and all liability claims, demands and causes of action whatsoever, arising out of my participation in or attendance at this event and related activities-whether resulting from the negligence of any of the above or from any other cause.  I agree that my assumption of risk and release hereunder shall be as broad and inclusive as is permitted under applicable law. If any portion of this agreement is held invalid, the remainder shall continue in full force and effect. I grant full permission in perpetuity to the organizers or this event to use, reuse, publish and republish my name and image as a participant in the event in photographs, video or other  recordings. I have read, understand and agree to the terms of this agreement. If participant is a minor or acts in accordance with a legal guardian, the parent or guardian must sign and agree to the below. I am the parent and/or legal guardian of Participant and I hereby consent to his/her participation. I have read the forgoing agreement, and I hereby agree on behalf of myself and Participant to its terms.
Are you 18 years or older? (if no, a parent or guardian will need to sign your volunteer waiver form - the form will be emailed to you) *
Do you agree to the waiver above?  Required for all volunteers and walk participants *
Would you also like to participate in the Walk that day? *
Team Name
Thank you! 
If you have volunteered for the Butler & Warren or the Cincinnati Tri-State Walks, then a member of our volunteer coordination team will be in contact with you to reconfirm. If you have any questions please reach out to wteavolunteers.gc.mv@alz.org.  

For the other volunteer opportunities you will hear from one of our Walk leaders. Questions? Please email cincinnatichapterwalk@alz.org.

We appreciate you and your commitment to the Alzheimer's Association.
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