PSSS Liability Form

Puget Sound Seabird Survey Liability Waiver

First Name

Last Name

Date of Birth

Initials

I hereby give my consent to use my photographs according to the terms & conditions

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Liability Release Form

We ask all volunteers and participants in PSBO activities to sign a liability release form stating that they understand the risks involved with any field activity. If you have not signed one for the 2022 year, please read and sign the form.

If you prefer to print, sign, and mail your form to PSBO, please use this printable form and send it to :

Printable Liability Form

Puget Sound Bird Observatory

PSSS Volunteers

P.O. Box 25072

Seattle, WA 98165

Parent/guardian if under 18 years of Age

I hereby grant permission for publishing, in PSBO publications or newsletters, promotional brochures, film, television or other electronic media, any footage, pictures or sound in which the below named participant appears. Understanding that reasonable attempts will be made to notify the participant/parent prior to use of full names, I additionally consent to the use of the participant's name with these media releases.

Today's Date

Photo Release:

PUGET SOUND BIRD OBSERVATORY 2022 LIABILITY RELEASE FORM

I, will participate in research, training, and/or volunteer activities with members or affiliates of the Puget Sound Bird Observatory (PSBO) at a publicly or privately owned site in Washington State. I certify that I am physically capable, with or without reasonable accommodation, of undertaking these activities. I further certify that I have fully informed PSBO of any medical conditions or medications that could reasonably be expected to affect my ability to participate in the program. In case of medical emergency, I give consent for emergency medical treatment, and I agree to pay or reimburse those paying for any charges incurred for my medical treatment, including evacuation or hospital visits, not covered by my personal health insurance. Furthermore, I agree to follow the directions concerning personal safety and bird safety provided by the PSBO liaison or other PSBO affiliate.

I have carefully read this agreement and agree to its terms and conditions. I acknowledge that voluntary participation in any field trip involves inherent risks and hazards, including but not limited to physical injury and material loss from exposure to hazards such as adverse weather conditions, insects and wildlife, rough and unknown terrain, moderately strenuous exercise, and transport to and from field sites. I acknowledge that all risks cannot be prevented, and assume sole responsibility for risks associated with my participation in any PSBO event.