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Cowtown Great
American Cleanup
Individual Registration

If you need to cancel your registration, please call (817) 392-1234 or email  KFWB@fortworthtexas.gov
Verification Number (Leave this blank):

Cleanup Date:   April 2, 2016

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* Is this person the group leader?  
 
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T-Shirts are limited to the first 9,000 registered individuals that participate in the cleanup. 3XL and 4XL sizes available by calling 817-392-2046.

GROUP INFORMATION

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You must enter a Group Name - if you are not associated with a Group, just use your name.
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You must enter a Group Leader Name - if you are not associated with a Group, just use your name.




LOCATION INFORMATION



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RELEASE FORM

Volunteer Release of Liability, Hold Harmless and Indemnification Agreement

In consideration of the opportunity to engage in volunteer work during the Cowtown Great American Cleanup, the undersigned, my heirs and assigns, hereby waive all claims for injuries, damages or losses to my person or property which may be caused directly or indirectly, by any act, omission or negligence of the Cowtown Great American Cleanup and/or the City of Fort Worth (“City”), their officers, agents and employees, in the execution of the volunteer work. The undersigned, my heirs and assigns, hereby covenant and agree to indemnify and hold harmless the Cowtown Great American Cleanup and the City, their officers, agents and employees, from any and all costs, charges, claims, demands, losses, damages, causes of action, suits and liabilities of any kind, including the expenses of litigation, court costs and attorney’s fees, for injuries to, or the death or illness of any person, or for damage to any property, arising out of or in connection with my involvement in the volunteer work, regardless of whether such injuries, illness, death or damages are reasonably foreseeable or reasonably with the contemplation of the parties to this agreement. The undersigned, my heirs and assigns, hereby further covenant and agree not to sue the Cowtown Great American Cleanup and the City, their officers, agents, and employees for any matter which arises from the execution of the volunteer work.

Initial Waiver

I have read, understood, and accept the agreement above. My submission form shall act as my legal signature.

* Initials of registrant if over 18 years of age, or parent/legal guardian of minor, incapacitated, or mentally-challenged person.