VIPER PHOTOGRAPHY TEAM

THE VIPER RIDE PLUS™
Visually Impaired Patriots Experiencing the Road

THE DATE OF THIS VIPER EVENT
SUNDAY August 22, 2021

Thank you many times over for your consideration and support!

FULL NAME

ADDRESS

CITY STATE ZIPCODE

MOBILE PHONE

PREFERRED EMAIL ADDRESS

VERIFY EMAIL ADDRESS

DATE OF BIRTH (Format: mm/dd/yyyy)

T-SHIRT SIZE
SMALLMEDLRGXL2XL3XL

PHOTOGRAPHY SKILLS

Where did you first learn about THE VIPER RIDE™

Are you able to participate in a 15-30 minute interview via phone or in person?
YESNO

Are you willing and able to attend a DRESS REHEARSAL RIDE?
YESNO

If you plan on shooting on location for the actual RIDING portions of the event, attendance to at least one DRESS REHEARSAL may be required
TBD

What will be your mode of transportation to the event?
MotorcycleCage

What is your TIME AVAILABILTY for the day of event?

Do you have experience working with special needs people, for example blind, deaf, disabled, handicapped or physically challenged individuals?

PLEASE REVIEW CAREFULLY AND SIGN:
The undersigned acknowledges and agrees that:
1. I understand photographic and video equipment may be used to memorialize and document THE VIPER RIDE event. As such, I understand my image may appear in a public forum, such as the print or broadcast media or on a website, to acknowledge, promote, or advance the work of the THE VIPER RIDE program. I understand images may be in the form of videos, photographs, or other artistic or recorded media, to be used for the purposes of advertising, promoting, and/or publicizing THE VIPER RIDE via any media deemed acceptable by the organization. As a volunteer, I hereby release the photographer and THE VIPER RIDE organization from all claims and liability relating to said photographs. I hereby grant perpetual and irrevocable permission for my images to be used by THE VIPER RIDE, the VIPER Organization, any event sponsors, or any parties, individuals, or organizations acting as an agent or delegate of the ride or the managing ride organization. I also hereby waive any and all rights of compensation or ownership thereto.
2. I further understand and agree that medical insurance is the responsibility of the volunteer and that THE VIPER RIDE organization does NOT provide medical coverage or medical care. I understand and I accept all risks associated with THE VIPER RIDE activities and will not hold THE VIPER RIDE or The VIPER Organization responsible for any injuries incurred by me while participating in the THE VIPER RIDE event.

By checking this button you accept the above terms
I Accept
SIGNATURE

DATE SIGNED (Format: mm/dd/yyyy)

YOU MUST CHECK "I ACCEPT" above in order to submit

Please Note Completing and submitting this application does not guarantee you will be accepted as a volunteer