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Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, Miracle League of Johnston County will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
T-Shirt Size
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)

Waiver

The Town of Smithfield and the Miracle League of Johnston County (together, the “Parties”) are committed to conducting its recreation programs and activities in a safe manner and holds the safety of volunteers in high regard.
WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully. Be aware that in consideration for providing volunteer services, you are expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages, or loss which you may sustain as a result of participating in any and all activities connected to and associated with your volunteer services (including transportation services/vehicle operations, when provided). As a volunteer, I recognize and acknowledge that there are certain risks of physical injury to volunteers in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that I may sustain as a result of my volunteer services. I further agree to waive and relinquish all claims I may have (or accrue to me) as a result of my volunteer services against the Parties, including their officers, officials, agents, volunteers and employees. I do hereby fully release and forever discharge the Parties and their officers, officials, agents, volunteers and employees, from any and all claims for injuries, damages, or loss that I may have or which may accrue to me and arising out of, connected with, or in any way associated with my volunteer services. I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims.
PHOTO RELEASE By agreeing to participate in Miracle League of Johnston County games and other activities sponsored by the Miracle League of Johnston County, you understand and consent to the use of visual and audio recordings of your image and likeness, and those recordings may be used to promote Miracle League of Johnston County activities in print and on the internet.