Prescribed Burn Volunteer Sign Up & Health Declaration

If you are interested in assisting on our prescription burns, please fill out this form as accurately as possible. All information will be kept confidential.

FURTHER INFORMATION AND LIABILITY WAIVERS - Please read the following information IN DETAIL. Checking the "I agree" box at the end of each section indicates to our team that you have read and understand all the information below.

WHAT TO BRING

-  Clothing made of natural materials (100% cotton, wool)

- Hat made of natural materials

- Reusable water bottle

- Leather work gloves (if possible)

- Leather work gloves (if possible)

- Leather safety work boots

WHAT WE PROVIDE

- Nomex fire-retardant coveralls (Limited sizing available)

- Eye protection

- Potable water

WAIVER OF LIABILITY AND INDEMNITY, MEDICAL TREATMENT AUTHORIZATION

By providing your name and signature on the “Volunteer Sign In” form - you (“the Volunteer Participant”) agree to abide by the Alderville First Nation Black Oak Savanna (“Alderville BOS”) Terms and Conditions for Volunteer Work Days and this Release, Waiver of Liability and Indemnity, Medical Treatment Authorization and Photographic Release Agreement (“this Release”). Where the Volunteer Participant is under the age of eighteen (18) years it is also agreed to by the consenting parent or legal guardian of the Participant. 

TERMS AND CONDITIONS FOR VOLUNTEER WORKDAYS

1. Alderville BOS Volunteer Work Day events are extensions of Alderville BOS’s regular business. These events, their organizers and those attending, whether fully the responsibility of Alderville BOS or done in partnership with other groups or organizations are subject to the same operational policies and safety standards as Alderville BOS events.

2. Everyone has the right to refuse work they believe to be unsafe.

3. Alderville BOS, whether solely or in partnership, agrees to provide volunteers with a safe, healthy and (wherever possible) accommodating volunteer work environment. This includes but is not limited to: site specific orientation, health and safety overviews, appropriate training or instruction, appropriate safety equipment, and an environment free of any harassment or discrimination.

4. Volunteers are required to attend site orientations and safety talks every time they volunteer with Alderville BOS before the start of any planned activity or volunteer work.

5. Volunteers are required to provide a minimum standard of safety equipment for themselves, including but not limited to: appropriate clothing and footwear, sun hat, sun screen, bug repellent or any other items an individual might require while being in the out-of-doors for an extended period or as instructed prior to the volunteer event.

6. Volunteers must report all injuries, no matter how slight, to the event supervisor.

7. Alderville BOS reserves the right to refuse participation to any volunteer who does not adhere to Alderville BOS policy on Volunteer Work Day events. The Alderville BOS abides by a Zero Tolerance policy with regards to violence/bullying/harassment as well as on-site consumption of alcohol/recreational marijuana.

8. COVID19 restrictions will apply as per the Haliburton, Kawartha, Pine Ridge District Health Unit (https://www.hkpr.on.ca/) and as directed by Alderville First Nation Chief and Council (https://alderville.ca/ ).

ASSUMPTION OF RISK

1. agree, acknowledge and understand that participation with Alderville BOS will include activities which will take place out-of-doors, possibly in poison ivy, possibly during inclement weather, including physical labour (i.e.: native plant planting or other), prescribed burning, the use of hand tools (shovels and/or other non-power tools), and walking over rough terrain, in water or watercourses (“the Activities”);

2. agree, acknowledge and understand that while the health and safety of the Participant and staff is always the first priority for the Alderville BOS, such Activities are not totally without risk;

3. agree to assume the risk of injury or harm to the Participant in the Activities;

RELEASE, WAIVER OF LIABILITY AND INDEMNITY

4. agree to release the Alderville BOS from all liability, whether direct or indirect, and waive all claims, demands, damages, costs, expenses, actions or causes of actions arising out of or in consequence of any death, injury, loss or damage to my person or property or that of my child or ward, however caused, while attending at or participating in the Activities; including but not limited to, breach of the Occupier’s Liability Act;

5. agree to further waive and release the Alderville BOS from any recourse which I or my child or ward may now or hereafter have resulting from any decision of the Alderville BOS;

6. agree to indemnify the Alderville BOS from and assume full responsibility for any claims demands, damages, costs, expenses, actions or causes of actions it may incur arising out of or in consequence of any death, injury, loss or damage due to my participation or that of my child’s or ward’s attendance or participation in the Activities;

MEDICAL TREATMENT

7. consent (if unable to provide it or deny it myself) as the Participant or for my child or ward in the event of injury or illness while under the supervision of the Alderville BOS to receive first aid and/or any further medical attention that potentially may be required to the extent determined by, and at the discretion of Alderville BOS staff, emergency medical services, and licensed medical professionals;

PHOTOGRAPHIC RELEASE

8. agree to grant permission for images of the Participant captured during regular Alderville BOS Activities through video, photo and digital camera, to be used solely for the purposes of the Alderville BOS’s promotional material and publications and do hereby waive any rights of compensation or ownership;

OTHER

9. agree that this Release shall be governed by the laws of Ontario;

10. agree that if any portion of this Release is held invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue in full legal force and effect;

11. agree that no oral representations have been made.