2. City of Branson
   Community Volunteer Litter Pickup Event - March 2021

   Sign up below to join us for our first annual City of Branson Community Volunteer Litter Pickup Event!

4. First Name*
5. Last Name*
7. Street Address*
9. Company/Sponsor Affiliation
11. Phone Number*
12. Email Address*
14. Preffered Contact Method*
    -- Select One --EmailTextPhone Call
16. Select any or all dates that you will be helping*

    1. March 13th 8AM - 12PM - Ward I
    2. March 20th 8AM - 12PM - Ward II
    3. March 27th 8AM - 12PM - Ward III
18. Number in Party
    How many participants will you be bringing?
20. Release for Volunteer Cleanup Days*

    I, in consideration of receiving permission from the CITY OF BRANSON to participate in community service efforts, or to engage in the utilization of any of the services and facilities of the CITY OF BRANSON in support of those community service efforts, the receipt of such permission being hereby acknowledged, and in further consideration of receiving permission to participate, the undersigned does hereby release the CITY OF BRANSON, its agents officers, servants, and employees, of and from any and all liability, claims, demands, actions, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the undersigned, or any property of the undersigned, while in, on, or upon the premises or engaged in such community service activities, owned by, sanctioned by, or under the supervision of the CITY OF BRANSON.
    
    The undersigned being duly aware of the risks and hazards inherent upon engaging in such activities or participating in such activities, hereby elects voluntarily to enter upon the premises, and to engage in or participate in said activities knowing that said activities or participation may be hazardous. The undersigned hereby voluntarily assumes all risks of loss, damage, or injury, that may be sustained as the result of such participation and activities.
    
    NOW, THEREFORE, in consideration of the premises extended to me by the CITY OF BRANSON, through its officers and agents for such participation, I do hereby for myself, my heirs, personal representatives, remise, release, and forever discharge the CITY OF BRANSON and all of its officers, agents, and employees, acting officially or otherwise, from any and all claims, demands, actions, or causes of action, on account of any injury to me which may occur from such activities or participation.
    
    THIS IS A RELEASE – I HAVE READ AND UNDERSTOOD SAME BEFORE ACCEPTING
    
    

    1. Accept
22. Acknowledgment*

    By selecting yes below, you are acknowledging that you are at least 18 years of age and consent to a representative of the City of Branson reaching out to you via your preferred contact method.

    1. Yes
24. Thank you for your interest in our Community Cleanup Day. We will be reaching out to you shortly.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field