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Thank you for applying to volunteer for camp. Details about your volunteer shift, including confirmation of times and locations, will be communicated by our volunteer coordinator. Please watch your email for more information.

By submitting this form you consent to NubAbility running a background check.

Any questions? Please contact us at 618 357 1394 or info@nubability.org.
CONTACT INFORMATION

Name *
Title
First Name
Last Name
Suffix
Email *
Phone *
Address *
Address Line 1
Address Line 2
City
State
Zip
PLEASE TELL US ABOUT YOURSELF

Date of Birth *
Please note: Volunteers ages 14 and under must be accompanied by an adult.
T-Shirt Size *
Occupation or Year in School *
Place of Employment
Please provide if currently employed.
Job Title
Please provide if currently employed.
School
Please provide if currently a student.
Are you with a group who wants to work together?
If so, please enter the group name here.
Is this your 1st NubAbility volunteer experience? *

Will you need formal verification of hours worked? *

Please let us know if you are tracking hours for school work, employee matching grants, etc.
Are you a NubAbility parent? *

Are you a former camper? *

Do you have a limb difference?
If so, please describe your difference.
WHAT ARE YOUR VOLUNTEER INTERESTS?

Volunteer Days Available *






Volunteer Times Available *




I want to work.. *

Volunteer Interests *



























Lifeguard Certification
Members of our lifeguard team must be certified. If you would like to help on the lifeguard team, please provide certification information.
Professional Medical License
Members of our medical team must be an EMT/Paramedic/Firefighter, Physician's Assistant/Nurse Practitioner, M.D. or D.O., LPN or RN, PT or PTA. If you wish to assist on the medical team, please provide your professional medical license number.
Anything else you would like to tell us?
Have you volunteered before in a specific area? Do you have a special skill you would like to share?
RELEASES

I agree to the Liability Release that follows. *

I agree to the Media Release that follows. *


LIABILITY RELEASE

In consideration of being permitted to participate in any way at the NubAbility Athletics Camp and at any other host of NubAbility Coaches, Participants, Volunteers, Spectators and Parents for the Camp, including Social Outings, Camp Recommended Hotels or Private Host Homes, myself and my party agree to waive any liability for any circumstance that might occur on the part of NubAbility Athletics Foundation, Coaches, Staff, Volunteers, Board of Directors and the host facilities.

1. I/WE understand and agree that, if at any time, I/we feel anything to be unsafe, I/we will immediately take all precautions to avoid the unsafe area and refuse to participate further.

I/WE agree that if I/we am/are the parent(s) and/or legal guardian(s) of a minor child, I/we will instruct the child that prior to participating in the below NubAbility Athletics Foundation activity or event, he or she should inspect the facilities and equipment to be used. If at any time he or she believes anything is unsafe, he or she will immediately advise the officials of such conditions and refuse to participate further.

2. I/WE fully understand and acknowledge that:

(a) There are risks and dangers associated with participation in NubAbility Athletics Foundation events and activities which could result in bodily injury, partial and/or total disability, paralysis, and death.

(b) The social and economic losses and/or damages which could result from the risks and dangers described above could be severe.

(c) These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including but not limited to the Releasees named below.
(d) There may be other risks not known to us or not reasonably foreseeable at this time.

3. I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

4. I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the NubAbility Athletics Foundation, Coaches, Staff, Volunteers, Board of Directors and the host facilities used by the participant, including their owners, managers, promoters, lessees of premises used to conduct the NubAbility Athletics Foundation event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions, or instructions to engage in risk evaluation or loss control activities regarding the host facilities or events held at such facilities and each of their directors, officers, agents, employees (all for the purposes herein referred to as “Releasee”) FROM ALL LIABILITY TO THE UNDERSIGNED, my/our personal representatives, assigns, executors, heirs and next of kin, FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES ON ACCOUNT OF ANY INJURY, including but not limited to damage to property or the death of the participant, ARISING OUT OF OR RELATING TO THE EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEE OR OTHERWISE.

5. I/ WE hereby acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of the undersigned also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

6. THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

7. On behalf of the participant and individually, the undersigned parent(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite this release, the participant makes a claim against any of the Releasees, the parent(s) and/ or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf, and hold them harmless.

NubAbility Athletics Foundation
221 E. Main St
DuQuoin, IL 62832

Du Quoin Community School District 300
845 East Jackson Street
DuQuoin, IL 62832

City of Du Quoin
Box 466
Du Quoin, IL 62832

Du Quoin State Fairgrounds
655 Executive Drive
Du Quoin, IL 62832

Red Hawk Golf Course
6204 IL-154
Tamaroa, IL 62888

Du Quoin Swimming Indians Complex
640 W Park St
Du Quoin, IL 62832

I, the undersigned, HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT OR CLICKING ON I AGREE, AND HAVE SIGNED OR CLICKED AGREEMENT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME.

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MEDIA RELEASE

NubAbility Athletics Foundation is given my permission to release and/or use images and video footage of myself and our party that is captured by NubAbility staff photographers and videographers at as well as invited media at NubAbility Events, to local, regional and national media, NubAbility authored print and film projects, social networking sites, promotional and awareness materials, and websites.

Additionally, if I share photos or video on public social networking posts or websites, I agree to TAG NubAbility Athletics and to use the hashtag #DontNeed2.

I understand and agree to the Media Waiver above.