101 I Street, Sacramento, CA 95814 916 / 808-4980 Fax 916 / 808-5100
www.historicoldsac.org
Are you under the age of 18? YES NO If yes, please see attached consent form. Type of Volunteer: COSTUMED NON-COSTUMED
If costumed, what is your 1840s-1870s era character? ________________________________________________________ (Please attach photo) If costumed, do you need us to provide a costume? YES NO
Do you currently volunteer with either the California State Railroad Museum or Historic Old Sacramento Foundation? YES NO
Please choose the volunteer position that you are interested in:
COSTUMED NON-COSTUMED Ladies Venue Hospitality Saloon Security/First Aid Mercantile Ice/Water Distribution Miners Camp Set-Up (Wednesday and Thursday Prior) Roaming Character Tear-Down (Tuesday After) Gold Panning Bowling Bank/Gold Rush Economy Greeters Childrens Games Museum monitors Dentist/Doctor/Undertaker No Preference As Needed Justice of the Peace/Sheriff/Mayor Skits and street theatre No Preference As Needed
Availability: Please indicate which shifts below you would like to be scheduled for. SHIFT FRIDAY AUGUST 29TH SATURDAY AUGUST 30TH SUNDAY AUGUST 31ST MONDAY SEPTEMBER 1ST 9:30AM - 1:30PM
1:30PM-5:00PM
Orientation- MANDATORY: Please select which session you will be attending. Friday August 22 nd 5:30 PM Saturday August 23 rd 10:00 AM Last Name First Name
Address City State Zip Code Phone Number Email If non-costumed, what is your t-shirt size? If non-costumed, what name would like on your name tag? GRD Office Use Only
Name Tag T-Shirt Parking Meals ______________ 2014 Volunteer Application
Historic Old Sacramento Foundation 101 I Street, Sacramento, CA 95814 916 / 808-4980 Fax 916 / 808-5100 www.historicoldsac.org
2014 Consent Form To be completed by a legal guardian for all applicants under the age of 18.
Release and Indemnity Agreement
As the parent/guardian of ______________________________________, referred to in this agreement as my child, who will be participating in the 2014 Old Sacramento Gold Rush Days event, I understand that anyone acting on behalf of the Historic Old Sacramento Foundation (volunteers, staff, and Board of Directors) will take all reasonable steps to provide a safe environment for everyone who participates in the Gold Rush Days activities. I authorize the Historic Old Sacramento Foundation to make medical emergency decisions on behalf of my child, and I further acknowledge that the Historic Old Sacramento Foundation will not be held liable for any resulting medical charges or held liable in any other way. I am also aware that there are certain risks involved in these activities, which might result in personal injury or property damage, and by allowing my child to participate in such activities agree to accept all risks of injury or damage. I agree to allow the Historic Old Sacramento Foundation to use photos for promotional purposes that may contain images of my child. Furthermore, I agree to hold harmless the Historic Old Sacramento Foundation, its volunteers, staff, and Board of Directors for any liability on behalf of my child or myself. I also agree to indemnify the Historic Old Sacramento Foundation for any expenses of liability that result because of a claim made by or on behalf of my child. I understand that this agreement is binding to me, my child and anyone else acting on behalf of my child.
_______________________________________________________________________ Parent/Guardian Name (please print) Signature Date
Michael Sylvester Proctor v. South Carolina Department of Corrections Geraldine P. Miro, Warden, Allendale Correctional Institution, Individually and in Her Official Capacity Richard J. McCants Acting Warden, Personally and in His Official Capacity Yvonne Wilkins, Unit Manager, Personally and in Her Official Capacity Parker Evatt, Commissioner, South Carolina Department of Corrections, Personally and in His Official Capacity Jane Doe, Personally and in Her Official Capacity Richard Roe, Personally and in His Official Capacity, 86 F.3d 1152, 4th Cir. (1996)