Alameda Recreation and Park Department - (510) 747-7529

9th Annual

2012 TEEN HAUNTED HOUSE

Teen groups/clubs, individuals are needed to assist in planning, creating and working at our 9th Annual Teen Spook-tacular Haunted House this year! You will have the opportunity to have some fun and earn some community service hours through this project.

VOLUNTEERS NEEDED!

Meetings are held every Wednesday once school begins; set-up time, wrap-up, and operation of the Haunted House will be announced once Halloween approaches. A short term commitment is needed to ensure the success of this event. All proceeds will benefit the Teen Program. For more information, please contact Christina at (510) 747-7554 or visit www.cityofalamedaca.gov/recreation/special-events for event times and entrance fees.

FRIDAY - SATURDAY - SUNDAY OCTOBER 19, 20, 21, 26, 27 AND 28 SOUTH SHORE CENTER, ALAMEDA

Alameda Recreation and Park Department

(510) 747-7529

9th Annual Teen Haunted House 2012 Volunteer Application Form

Thank you for your interest in participating in our Teen Haunted House event to be held on Friday Sunday, October 19-21 and 26-28, 2012 at South Shore Shopping Center, Alameda. To register for a scene or volunteer, please complete this application form: Individual Teen: Club/Organization: Print - Advisor/Contact Name/Parent Name: Address: Home Phone: ( Fax: ( ) ) Cell Phone: ( City: ) Zip: School:

Are you creating a scene or volunteering on the evening of the event?

Meeting Dates & Times: Wednesdays, Sept. 26th, Oct. 3rd, 10th, 17th, 24th, 31st Veterans Memorial Building, from 4:30 p.m. 5:00 p.m., RM. 390 (September 26th & October 31st) South Shore Retail Space, from 4:30-5:00 p.m. (October 3rd, 10th, 17th, 24th)
THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:
1. THE UNDERSIGNED HEREBY RELEASES, WAIVES AND DISCHARGES THE CITY OF ALAMEDA, its directors, officers, employees, agents, and independent contractors from all liability to the undersigned and/or his/her personal representatives, assignees, heirs, and next of kin for any loss or damage and any claim or demands accruing or resulting from injury to the person or property or death of the undersigned, whether or not caused by the negligence and/or property or the City of Alameda, its directors, officers, employees, agents, and independent contractors. 2. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER OR NOT IT IS, due to the negligence of the City of Alameda, its directors, officers, employees, agents, and independent contractors or otherwise while in, upon or about the premises of the City of Alameda and/or while using the premises or facilities or equipment thereon. 3. THE UNDERSIGNED HEREBY PERMITS the taking of photographs of themselves and/or the participant by the City of Alameda throughout the entire event to be used at the City's discretion. THE UNDERSIGNED HAS READ AND HEREBY VERIFIES BY MY SIGNATURE BELOW THAT I FULLY UNDERSTAND EACH OF THE ABOVE CONDITIONS OF THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement has been made. I HAVE READ THIS RELEASE. Teen Volunteer Signature: Advisor Signature: Parent Signature: Date: Date: Date:

PLEASE RETURN FORM BY THURSDAY, October 4, 2012 To: Alameda Recreation and Park Department 2226 Santa Clara Ave., Alameda, CA 94501 Attention: Christina Bailey For questions, please call (510) 747-7554.