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Required fields are marked with an asterisk (*). First Name *
Last Name *
Birthdate *
A valid date as MM/DD/YYYY (for example: 11/30/2015)
What is your specialty and what is your workplace/organization? (e.g., critical care, oncology, emergency, at Emory/Well Star, etc) *
Company/Group/Organization, if applicable
Address *
Apt., Ste., Bldg#
City *
State *
Zip *
Mobile Phone Number *
Shirt Size *
How many years have you volunteered for the AJC Peachtree Road Race, including the upcoming 2023 event? (Please use numbers only, no text) *
Emergency Contact Name *
Emergency Contact Phone # *
FCC Call Sign *
What are your Digital Capabilities? *
Member Organization (ie, DeKalb ARES, Atlanta Radio Club, etc.)
HAM Operators, any Special Requests? (Same location as last year, Try something new, work with a friend, etc)
Volunteer Code of Conduct Policy #1 *
Policy #2 *
Policy #3 *
Policy #4 *
Policy #5 *
Disclaimer
I ("Volunteer") understand that my participation as a volunteer in connection with the 2023 AJC Peachtree Road Race on July 4, 2023("Race") involves (i) interaction with, among others, Atlanta Track Club ("ATC") staff, other Race volunteers, Race spectators and bystanders, law enforcement personnel, vehicular traffic, roadway hazards, the effects of the weather, and Race participants and (ii) activities that may be hazardous to Volunteer, including, but not limited to, injury, disease, and even death. ATC does not guarantee Volunteer's health or safety and does not assume any responsibility or risk of bodily injury, sickness, property damage or loss, and/or death. Volunteer hereby expressly and specifically assumes the risk of bodily injury, sickness, property damage or loss, and/or death that may arise out of or result from participation as a volunteer in connection with the Race. I ("Volunteer") understand that my participation as a volunteer in connection with the AJC Peachtree Road Race. For good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Volunteer and ATC, Volunteer, for and on behalf of him/herself and the heirs, successors, beneficiaries, and assigns of Volunteer, does hereby covenant not to sue, releases, waives, forever discharges, and holds harmless ATC, its officers, directors, staff, employees, agents, volunteers, successors, and assigns (collectively, the "Released Parties"), from any and all liability, claims, demands, and causes of action of whatever kind or nature, either in law or in equity, arising out of or relating to (i) Volunteer's participation as a volunteer in connection with the Race and (ii) any first aid or medical treatment rendered to Volunteer in connection with the Race. Without limiting the generality of the foregoing sentence, Volunteer understands and agrees that the foregoing covenant not to sue, release, waiver, discharge, and hold harmless discharges the Released Parties from any liability or claim that Volunteer may have against a Released Party for bodily injury, sickness, property damage or loss, and/or death, regardless of whether such bodily injury, sickness, property damage or loss, and/or death is caused in part by the act or omission of a Released Party. Volunteer agrees that the covenant not to sue, release, waiver, discharge, and hold harmless set forth above are intended to be as broad and inclusive as permitted by law.
Volunteer grants permission to all of the Released Parties to use any photographs, motion pictures, recordings, or any other record of the Race (which may contain Volunteer's image) for any legitimate purpose. Furthermore, Volunteer understands that ATC, in its sole discretion, retains the absolute right to excuse and bar Volunteer's participation as a volunteer in connection with the Race for any reason whatsoever when it deems Volunteer's behavior inappropriate. Finally, Volunteer understands that ATC may prohibit Volunteer's participation as a volunteer in connection with the Race if Volunteer does not present a valid government issued form of identification the day of the Race.
I ("Volunteer") understand that my participation as a volunteer in connection with the 2023 AJC Peachtree Road Race on July 4, 2023("Race") involves (i) interaction with, among others, Atlanta Track Club ("ATC") staff, other Race volunteers, Race spectators and bystanders, law enforcement personnel, vehicular traffic, roadway hazards, the effects of the weather, and Race participants and (ii) activities that may be hazardous to Volunteer, including, but not limited to, injury, disease, and even death. ATC does not guarantee Volunteer's health or safety and does not assume any responsibility or risk of bodily injury, sickness, property damage or loss, and/or death. Volunteer hereby expressly and specifically assumes the risk of bodily injury, sickness, property damage or loss, and/or death that may arise out of or result from participation as a volunteer in connection with the Race. I ("Volunteer") understand that my participation as a volunteer in connection with the AJC Peachtree Road Race. For good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Volunteer and ATC, Volunteer, for and on behalf of him/herself and the heirs, successors, beneficiaries, and assigns of Volunteer, does hereby covenant not to sue, releases, waives, forever discharges, and holds harmless ATC, its officers, directors, staff, employees, agents, volunteers, successors, and assigns (collectively, the "Released Parties"), from any and all liability, claims, demands, and causes of action of whatever kind or nature, either in law or in equity, arising out of or relating to (i) Volunteer's participation as a volunteer in connection with the Race and (ii) any first aid or medical treatment rendered to Volunteer in connection with the Race. Without limiting the generality of the foregoing sentence, Volunteer understands and agrees that the foregoing covenant not to sue, release, waiver, discharge, and hold harmless discharges the Released Parties from any liability or claim that Volunteer may have against a Released Party for bodily injury, sickness, property damage or loss, and/or death, regardless of whether such bodily injury, sickness, property damage or loss, and/or death is caused in part by the act or omission of a Released Party. Volunteer agrees that the covenant not to sue, release, waiver, discharge, and hold harmless set forth above are intended to be as broad and inclusive as permitted by law.
Volunteer grants permission to all of the Released Parties to use any photographs, motion pictures, recordings, or any other record of the Race (which may contain Volunteer's image) for any legitimate purpose. Furthermore, Volunteer understands that ATC, in its sole discretion, retains the absolute right to excuse and bar Volunteer's participation as a volunteer in connection with the Race for any reason whatsoever when it deems Volunteer's behavior inappropriate. Finally, Volunteer understands that ATC may prohibit Volunteer's participation as a volunteer in connection with the Race if Volunteer does not present a valid government issued form of identification the day of the Race.
Check here to show you accept the terms stated above for yourself or for a minor Volunteer for which you are the parental guardian.
