Macomb Community College

Thank you for volunteering to participate in Macomb Community College’s MLK Jr. Day of Service. Please complete the following information to finalize your registration.

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

On campus Monday, January 20, 9am-12pm

Your Information

First Name: *

Last Name: *

Address: *

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Email: *

A confirmation will be e-mailed to this address. Please check it regularly for updates about the event.

Phone Number: *

(xxx) xxx-xxxx
(Please provide a number where you can be reached the day of the event if needed.)

Date of Birth: *

Volunteers under 18 years of age must be accompanied by a parent or legal guardian. Parents/legal guardians will be required to complete and sign a liability waiver prior to minors volunteering.

Macomb ID #: *

Affiliation: *

T-Shirt Size:

T-Shirts are available on a first come, first served basis. Sizing is not guaranteed.

Do you want to be eligible for MMII credit? *

(If you are interested in MMII credit you will be sent a separate email with instructions.)

Are you registering anyone else from your household?
(Members outside of your household must complete
a separate registration form)

Registrant #2

First Name:

Last Name:

T-Shirt Size:

T-Shirts are available on a first come, first served basis. Sizing is not guaranteed.

Registrant #3

First Name:

Last Name:

T-Shirt Size:

T-Shirts are available on a first come, first served basis. Sizing is not guaranteed.

Registrant #4

First Name:

Last Name:

T-Shirt Size:

T-Shirts are available on a first come, first served basis. Sizing is not guaranteed.

Release Waivers

CONSENT: *

Consent to Record Image and Voice. The individual identified above (hereinafter “Participant”), in consideration for being permitted to participate in the event identified above, unconditionally and irrevocably voluntarily consents to being photographed, videotaped and/or audio taped by the Macomb Community College (“the College”) and exhibitors (if applicable) (hereinafter referred to collectively as “exhibitors”).

Consent to Use of Image, Voice and Testimonial. Participant unconditionally and irrevocably voluntarily authorizes the College and Exhibitors to use Participant’s name, image, likeness, voice, and/or testimonial for purposes of advertising, marketing, promoting, or publicizing the College and/or College programs, or for any other lawful purpose.

Forms of Media. Participant unconditionally and irrevocably authorizes College and Exhibitors to publish Participant’s name, image, likeness, voice, and/ or testimonial in any form of media, including any media that may be developed or created in the future. Such forms of media may include, but are not limited to: radio; television; multimedia presentations; social media; websites, and printed publications.

No Right to Approve. Participant waives any right to inspect or approve the finished product, including written copy, wherein Participant’s name, image, likeness or testimonial appears.

No Compensation. Participant hereby waives all rights to compensation or other consideration for the rights granted to College or Exhibitors under the terms of this Agreement.

Release of Liability. In consideration of Participant being permitted to participate in the Macomb Community College Program(s) named above, Participant’s Parent or Guardian, hereby release, discharge and covenant not to sue Macomb Community College, its trustees, officers, agents and employees from all liability for any and all claims, damages, costs or causes of action I/we have or may participating in the above Program(s).

Governing Law. This waiver and release shall be governed by and construed in accordance with the laws of the State of Michigan. The participant or participant’s parent/guardian acknowledges, by his/her signature below, that (s)he has read this document and release, that (s)he understands its terms and conditions, and that (s)he agrees to be bound by its terms and conditions as an express condition of participation in the event. Participant or participant’s parent/guardian further represents that (s)he is at least eighteen (18) years of age and is fully competent to sign this agreement.

Electronic Signature. The parties may enter into this Agreement by electronic means by typing their name, and date of execution on the lines provided at the end of this Agreement and emailing or digitally submitting it to the other party with the words “Accepted Agreement” in the subject line of the email. The parties agree that electronic execution and delivery as provided herein shall have the same force and effect as delivery of an original document with original signatures.