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Community Bike Path Painting Event
SATURDAY, SEPTEMBER 30, 2023 • NOON - 5:00 PM
Sign up to participate online through Thursday, September 28 at noon.
Questions? Please submit using the form, and someone will get back to you promptly!

PLEASE NOTE:
- Volunteers under 14 must be accompanied by and Adult/Guardian with written consent from Guardian (At end of Waiver Information) and complete a Volunteer Registration Form.
- Adult supervision required for children.
- This event involves paint and chalk. Please dress appropriately.
* INDICATES A REQUIRED FIELD.
PARTICIPANT:
Full Name*
Age*
Date of Birth*
Address*
City
State
Zip Code
Phone Number (Home)
Phone Number (Cell)
Email Address*
Parent/Guardian's Email Address (14 and under participants)
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Participation Waiver

I hereby give my approval for my participation in any/all activities during the Town of Barrington’s Community Bike Path Painting Event event. I assume all risks and hazards incidental to such participation, including transportation to and from such activities, and hereby waive, release, absolve, indemnify, and agree to hold harmless all individuals responsible for the conduct or activity involving this program.
MEDICAL CONDITIONS: I understand that myself or my children requiring special attentions are reviewed on a case-by-case basis with the Coordinator(s). I understand that this program does not receive specialized training for various special needs, but will work with individuals as appropriate. I will provide as much detail as possible, including any physical/emotional needs or medications involved.
Please provide information below if you have any Medical Conditions and/or Food/Environmental Allergies:
RISK FACTORS: The undersigned understands and acknowledges that the use of equipment, facilities and services provided by the Town of Barrington involves risks such as, but not limited to the following which might result from the use of equipment or facilities, from the activity itself, from the acts of others, or from the unavailability of emergency medical care – RISK OF PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH, and that the volunteer assumes all risks that arise from, but not limited to, those risk factors described above.
RELEASE: The undersigned releases the Town of Barrington, its employees and agents, and agrees not to sue them on account of or in conjunction with any claims, causes of action, injuries, damage, cost of expenses arising out of the activity, including those based on death, bodily injury or property damage whether or not caused by the acts, omissions or other fault of the parties being released.
EMERGENCY TREATMENT CONSENT: The undersigned, as a participant in the subject activity, hereby consents to medical treatment in a medical emergency where the undersigned is unable to consent to such a treatment.
ACKNOWLEDGEMENT: The undersigned has read and understands the agreement. I give permission to be photographed unless I opt out by providing a written letter asking not to be photographed.
COVID-19 DISCLAIMER: Without in any way limiting the scope of the foregoing assumption of risk and waiver, and release of liability, all participants specifically acknowledge, assume, and release the Town of Barrington from any and all liability that is any way related to risks resulting from the COVID-19 novel coronavirus pandemic. MASK IS OPTIONAL.
Please check one:*
1. Yes, I give permission to be photographed
2. No, I do not give permission to be photographed
Acknowledgement*
1. I acknowledge that this is a painting event, and the Town is not responsible for paint on clothing/personal items. Please dress accordingly.
2. I have read the above waiver and understnad the agreement.
Participant's Name/Signature:*
Date:*
Date:
Parent/Guardian's Name/Signature:
Volunteers under 14 must be accompanied by an Adult/Guardian and provide written consent from Guardian. Organizers will follow up to confirm.
Once you submit the form, you are all set!
The Bicycle-Pedestrian Advisory Committee looks forward to seeing you on Sunday, September 24!

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