Volunteer Registration Form
Please read each of the following items before choosing a selection below.
1) Victoria Acres Equine Facility, Inc. to use my (my child's) photograph or image in its print, online and video publications ;
2) Release Victoria Acres Equine Facility, Inc., its employees and any outside third parties from all liabilities or claims that I might assert in connection with the above described activities ; and
3) I waive any right to inspect, approve or receive compensation for any materials or communications, including photographs, videotapes, DVD's, website images or written materials incorporating photos / images of me (my child)
I hereby consent to and authorize the aboveI DO NOT consent to, nor do I authorize the above
In the event emergency medical aid / treatment is required due to illness or injury while being on the property of Victoria Acres, I authorize Victoria Acres to:
1) Secure and retain medical treatment and transportation, if needed.
2) Release records upon request to the authorized individual or agency involved in the medical emergency treatment.
(to be invoked in the event that your emergency contact cannot be reached)
I give consent for emergency medical treatment / aide (including X - ray, surgery, hospitalization, medication and any treatment procedure deemed "life saving" by a physician in the event of illness or injury while on the property of Victoria Acres.