The volunteer application collects an applicant's contact information, availability, and areas of interest for volunteering at a September 17, 2011 event hosted by the Jon Drummond Achievement Foundation, and requires the applicant to sign a waiver releasing the organization from liability and agreeing to volunteer without pay.

1. 2011 VOLUNTEER APPLICATION
PART I.
Name ______________________________________________________ Date of Birth _____/_____/_______ Age __________
I certify that I am 18 years of age or older as of 9-17-11.
Address _______________________________________________/_________________________/_____ /_________________
Street City State Zip
Primary Contact #: _______________________________________ Alternate Contact #: _______________________________
Email___________________________________________________________________________________________________
Organization/Company Affiliation (if any):_____________________________________________________________________
PART II.
TIME PREFERENCE AREA(S) OF INTEREST
check all that apply check all that apply
Fri., Sept. 16: TBD Set Up (all areas)
Sat., Sept. 17: All Day Registration
Sat., Sept. 17: 6:00 am – 9:00 am Games Management
Sat., Sept. 17: 9:00 am – 12:00 pm Entertainment / Stage Crew
Sat., Sept. 17: 12:00pm – 3:00 pm Empowerment Zone
Sat., Sept. 17: 3:00 pm – 5:00 pm Security: Stage
Security (all areas)
Break-down (all areas)
Saturday, September 17, 2011
ParkWest Town Center ● 52nd & Jefferson Streets ● Philadelphia, PA
PART III.
I, (print your full name) _________________________________________ certify that I am offering my services to the Jon
Drummond Achievement Foundation (JDAF) on a volunteer basis. I understand that I will receive no pay, benefits or other
privileges of employment of any kind for my services. I further understand that I am not eligible for worker’s compensation
benefits if I am injured or become ill as a result of my volunteer work. I also certify that I have not been promised and have no
expectation that I will receive a paid position as a result of my volunteer work.
The undersigned on behalf of themselves and their estate, hereby waives any right of recovery and releases the Jon Drummond
Achievement Foundation, their officers, officials, employees and agents, from liability related to or arising from any and all
injury to persons and damage to property during the Street Games event. Undersigned further agrees and undertakes to
indemnify, hold harmless and defend the JDAF from and against any and all claims, damages, actions, liability and expenses
including attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or
damage to property arising from or out of the Undersigned’s activities and participation in volunteer services at the above
Street Games Event. The Undersigned further acknowledges and agrees that the JDAF does not assume any responsibility
whatsoever for any property of the Undersigned and the Undersigned shall not hold the JDAF liable for any loss or damage to
same. The undersigned gives their permission to be photographed, videotaped and have their image used in Jon Drummond
Achievement Foundation publications.
Your Signature _______________________________________________ Today’s Date _____________________