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Sponsors:
Delta Music Experience
Red Apple
Granite Graphics
 
KPLU
 
Methow Arts
 

2012 Winthrop R&B Festival
VOLUNTEER/STAFF FORM

Winthrop R&B Festival VOLUNTEER/STAFF FORM
Name *

First
Last
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Phone Number *

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### 		-
####
Best time to reach you:
 Between 8 and 10 a.m. 
 Between 10 a.m. and 12 p.m. 
 Between 12 p.m. and 2 p.m. 
 Between 2 p.m. and 4 p.m. 
 Between 4 p.m. and 6 p.m. 
 After 6 p.m. 
Email *
Position Desired: *
Dates Available: *
WDL# OR SS#: *
Age: *
Past WBF volunteer experience? Comments:
Emergency Contact: *
Please provide a name and phone number.
Have you ever been convicted of a felony?
 Yes 
 No 
If yes please explain:
Are you a registered sex offender?
 Yes 
 No 

'I Agree' (Please Read Carefully)
I understand and agree that submitting this application form does not automatically register me as a Winthrop Rhythm & Blues Festival volunteer. By submitting this form, I attest that the information I have provided on the form is true and accurate.

If I am accepted as a volunteer, I agree to the following:
-To satisfactorily complete my scheduled shifts.
-To arrive on time to my scheduled shifts.
- At NO TIME will I be under the influence of alcohol or drugs during my shifts.
-To be an ambassador of good will for the festival and to treat festival patrons with respect and courtesy.
I understand if I fail to meet any of the above requirements it may result in the forfeiture of my festival pass.

Upon acceptance as a volunteer I agree to notify the volunteer coordinator by no later than July 1, 2011 if I find I am unable to participate.

I understand that neither the Winthrop Music Association nor any of its officers, employees, or volunteers shall be held liable for any claims seeking damages for personal injury or property damage that may arise out of my participation as a volunteer for the festival. I further agree to indemnify the Winthrop Music Association, its officers, employees, volunteers harmless on account of any such claims.
Do you agree with the terms and conditions? *
 Yes, I agree. 
Signature: *
Date *

MM 		/
DD 		/
YYYY
If you purchased a ticket or camping pass and successfully completed volunteer shifts:

Proof of purchase provided
Person confirming shifts worked
Amount refunded:
Signature for receipt of funds:
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