Date

MM

DD

YYYY

Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone

(###)

###

####

Emergency Contact Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What days & times are you available to volunteer?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

What are your main interests in volunteering with us?

Learning new gardening skills

Connecting with Nature

Sustainable/Regenerative agriculture

Helping the Community

Other:

Do you have any physical limitations, allergies, or medical conditions that we should be aware of?

Yes

No

I acknowledge and agree to abide by this Code of Conduct.

Date

MM

DD

YYYY

I acknowledge that volunteering with Ellume Gardens, Inc. may involve physical labor, exposure to outdoor conditions, insects, allergens, tools, and other potential hazards. I understand and accept that there are inherent risks in these activities. I hereby release, indemnify, and hold harmless Ellume Gardens, Inc./Greencourt Group, Inc., its owners, employees, and affiliates from any and all liability, claims, or demands that arise from my participation as a volunteer. I understand that a) I am volunteering at my own risk and will exercise caution and good judgment; b) I am responsible for any personal medical insurance coverage in case of injury; c)I will follow all safety guidelines and instructions provided by Ellume Gardens, Inc. *

First Name

Last Name

Phone

(###)

###

####

I agree to the terms above.

Date

MM

DD

YYYY

I grant permission to Ellume Gardens, Inc. to use photographs, videos, or other media of me taken during volunteer or workshop activities for promotional, education & marketing purposes. *

First Name

Last Name

Yes, I agree

No, I do not consent

Date

MM

DD

YYYY