Volunteer Registration Form

GET REGISTERED TO VOLUNTEER WITH FEED & SEED IF THIS IS YOUR FIRST TIME

Volunteer Registration - Step 1 of 4

Volunteer Registration

Volunteer First and Last Name *

Are you volunteering with a group? If yes, please list the group name and the volunteer date. *

Email Address *

*If the volunteer is under 18, please list parent or guardian's email address*

Volunteer Phone Number *

Volunteer's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Is the volunteer under 18 years old? *

Do you have any physical limitations? If yes, please describe. *

Emergency Contact's First and Last Name *

Emergency Contact's Phone Number *

Emergency Contact's Email Address *

*If the volunteer is under 18, please list parent or guardian's email address*

Emergency Contact's Relationship to Volunteer *

Volunteer Waiver

VOLUNTEERS MUST COMPLETE THE BELOW WAIVER AND RELEASE OF LIABILITY FORM. (Parent/Legal Guardian's Signature is Required if Volunteer is under 18 years old) *Note: This is your official volunteer waiver and release of liability form.*

Waiver Information

In return for being allowed to participate in Feed & Seed’s volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, or “my”) releases and agrees not to sue the Feed & Seed Co or its officers, directors, employees, sub-contractors, sponsors, agents and affiliates from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of my participation in the Volunteer Activities wherever, whenever, or however the same may occur. I understand and agree that Feed & Seed Co are not responsible for any injury or property damage arising out of the Volunteer Activities, even if caused by their ordinary negligence or otherwise. I understand that participation in the Volunteer Activities involves certain risks, including, but not limited too, serious injury and death. I am voluntarily participating in the Volunteer Activities with knowledge of the danger involved and I agree to accept all risks of participation. I also agree to indemnify and hold harmless Feed & Seed for all claims arising out of my participation in the Volunteer Activities. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I also acknowledge that Feed & Seed Co have not arranged and do not carry any insurance of any kind for my benefit or that of Volunteer (if Volunteer is under 18), my parents, guardians, trustees, heirs, executors, administrators, successors and assigns. I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Volunteer Activities. I also understand that this document is a contract which grants certain rights to and eliminates the liability of the Feed & Seed Co.

First and Last Name of Signer *

If the volunteer is under 18 years old, please enter the parent/legal guardian's name

Signature (Parent/Legal Guardian must sign on behalf of the volunteer if the volunteer is under 18)

I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies.

Publicity Release

In return for being allowed to participate in Feed & Seed Co volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, or “my”) hereby grants to Feed & Seed Co, and each of its subsidiaries, affiliates, agents, advertising or promotional agencies, and partners, and all such entities’ officers, directors, agents, employees, respective successors and assigns (collectively, “Authorized Parties”), the absolute and irrevocable right and permission to use, publish, broadcast and/or copyright the use of Volunteer’s name, address, voice, photograph and/or likeness, caricature, and personal information, in its current form or as retouched, digitized, cropped, altered, distorted or modified in any way, in any and all advertising, promotional, or other materials based upon or derived from the Volunteer Activities in any manner, in any media whatsoever for any and all purposes, including by way of example but without limitation advertising, promoting or publicizing products and services throughout the universe, in perpetuity, in any and all media now known or hereafter devised (including without limitation on the Internet), without additional compensation. I further agree that anything derived there from will be owned solely by the Authorized Parties. I shall not authorize the use of any print, negative or other copy thereof by anyone other than the Authorized Parties. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect.

First and Last Name of Signer *

If the volunteer is under 18 years old, please enter the parent/legal guardian's name

Signature (Parent/Legal Guardian must sign on behalf of the volunteer if the volunteer is under 18)

I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies.

Volunteer Health Form

It is the policy of Feed & Seed Co., located at 701 Easley Bridge Road, Suite 6010, Greenville SC 29611, in an effort to prevent the transmission of diseases through food by infected food service volunteers, to reference South Carolina Regulation 61-25, Section 2-103.11(O)-(P). These sections provide guidance for the exclusion, restriction, and reinstatement of ill employees/volunteers who have been observed or have reported their health status and related health conditions related to preventing the transmission of illnesses due to Norovirus, Salmonella Typhi, Shigella ssp., Shiga Toxin-producing Escherichia coli (STEC), nontyphoidal Salmonella, or Hepatitis A virus. The purpose of this policy is to inform food service volunteers of their responsibility to notify the Person in Charge (PIC) when they experience any of the conditions listed so that the PIC can take appropriate steps to prevent the transmission of foodborne illness.

The food service volunteer MUST report to the PIC the onset of the following symptoms, either while volunteering or outside of volunteering, to include the date of onset.

• Diarrhea • Vomiting • Jaundice • Sore throat with fever • Infected cuts, wounds, or lesions (containing pus on the hand, wrist, or any other exposed body part) and cuts, wounds, or lesions that are not properly covered (such as boils and infected wounds).

The food service volunteer MUST report to the PIC any diagnosis of the following illnesses:

The food service volunteer MUST report to the PIC any exposures to foodborne pathogens such as:

• Exposure to, or suspicion of causing, any confirmed disease outbreak of Norovirus, Typhoid Fever, Shigellosis, E. coli 0157:H7 or other STEC infection, or Hepatitis A. • Exposure to a household member diagnosed with Norovirus, Typhoid Fever, Shigellosis, illness due to STEC, or Hepatitis A. • Exposure to a household member who visits or works in a location experiencing a confirmed disease outbreak of Norovirus, Typhoid Fever, Shigellosis, E. coli 0157:H7 or other STEC infection, or Hepatitis A.

First and Last Name of Volunteer *

Signature of Volunteer (even if under 18 years old) *

GET REGISTERED TO VOLUNTEER WITH FEED & SEED IF THIS IS YOUR FIRST TIME