Each individual must complete the form.

(Please print legibly)

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Name (First) (Last)

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Volunteer Group, School, and/or Organizations Name

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Address, City, State, Zip

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Cell Phone

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E-Mail (Required)

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Emergency Contact Name and Phone

Volunteer Registration Form
Registration & Packet- Pick Up:
Friday, June 13, 2014
Location TBD
Shifts/ Times 11:00 am- 8:00 pm


Saturday, June 14, 2014
The Great Park, Irvine

Shifts/ Times please select one
All Day 7:00am- 3:00pm *most volunteers needed
6:00 am- 11:00 am
10:30 am- 3:30 pm

T-Shirt Size (circle one)
Small Medium Large X-Large
Waiver: I (Volunteer) wish to serve as a volunteer for the Gladiator Rockn Run (the Event). In consideration of
the opportunity to serve as a volunteer for the Event, Volunteer agrees, acknowledges and represents: 1) that he/she
is aware of the inherent risks to person (including significant injuries or death) or property involved in the Event,
which Volunteer understands is a strenuous and hazardous athletic event; 2) Volunteer agrees, on his/her own behalf
and on behalf of Volunteers heirs, estate, successors and assigns, to indemnify and hold harmless Gladiator Events,
LLC, and all landowners, producers, sponsors, co-sponsors, advertisers, organizers, material suppliers, participants
and/or contractors of any of the Event, (collectively, the Released Parties) against, any lawsuits, demands, claims,
or expenses (including attorneys fees and legal costs), arising from or in any manner related to Volunteers service as
a volunteer for the Event; and to the fullest extent permitted by law, Volunteer fully and forever waives, releases,
discharges and covenants not to sue Released Parties for and from any and all demands, claims, actions, suits,
damages, losses, liabilities, costs and expenses arising, directly or indirectly, in related to, in connection with or
relating to Volunteers service as a volunteer for the Event from any cause; and 3) Volunteer hereby grants to
Gladiator Events, LLC the worldwide right in perpetuity to use and publish Volunteers name, Volunteers likeness,
Volunteers voice, and/or Volunteers picture, singly or as part of composite or reproductions, in color or otherwise,
in any medium now known or in the future devised, including but not limited to, broadcast, telecast, advertising,
promotion, or other account of the Event in any form and for any purpose, without compensation or approval.

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Signature of volunteer (Parent or guardian if under 18 years) Date
Please call or email us with your intent, then fax, mail or e-mail completed forms to Talk About Curing Autism (TACA)
2222 Martin Street Suite 140, Irvine CA 92612 Fax 949.640.4424 Tel 949.640.4401 susie.lemus@tacanow.org
More info at www.gladiatorrocknrun.com