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City of Roswell Media Volunteer Form

  1. MediaReleaseFormHeader-01

  2. Would you like to help your city government let everyone know about the services it provides to the community? The City of Roswell is looking for volunteers to be featured (as actors) in online videos that promote city services. Volunteers of all ages are needed. This volunteer project does not offer pay, but does provide an opportunity to contribute to your community in a fun and unique way! Complete this form to be added to our volunteer list.

  3. When are you available to volunteer?

  4. I further certify that all the information contained herein is true to the best of my knowledge. By signing this application, I hereby acknowledge and agree that I am not an employee or agent of the City of Roswell and that I am not entitled to any remuneration or benefits provided to employees of the City of Roswell, including but not by way of limitation, wages, retirement, worker’s compensation, insurance or disability.

  5. I understand that the City of Roswell is seeking photographs/videos for publications (print and website based-electronic) and dissemination to the press to assist in informing the general public about the work the city of Roswell does to help illustrate the scope and benefits of city services/use. I understand that only names, the name of facility (Library, Museum, Parks & Recreation, Visitor Center, etc.), and the city may be used to identify the written comments, photographs, videos, and audio. I authorize and consent to being photographed and/or videoed, and to the display, reproduction, alternation or other use of any photographs/videos of me, or in which I may be included with others, in connection with City of Roswell publications, website, and press contacts. To the extent that I have rights, title, or interests in the photographs or videos, I assign such rights to the City of Roswell. I release and hold harmless the City of Roswell and their agents and employees from and against any claims or liability arising from or related to the use, publication or distribution of the comments/photographs/videos/audios. In giving this permission, without fee or limitation whatsoever, and in consideration of the opportunity to participate in the publications, website, or dissemination of press material, I agree to release, discharge, and hold harmless the City of Roswell and their employees, from any and all claims, actions and demands or whatsoever nature, including but not limited to any claims of libel, or invasion of privacy, arising out of or in connection with the use of my photograph or video. I authorize and consent to being photographed*

  6. For Persons 17 and Under

  7. By signing below, and in consideration of my acceptance as a volunteer, I do hereby agree, for myself, my heirs, my personal representatives and assigns to release , waive and hold harmless the City of Roswell, it’s officers, employees and agents from any and all claims for damages resulting in injury, including death, or damage to or loss of personal property, including any vehicle operated by me, which occurs in connection with or arising out of my participation in the aforesaid volunteer activities.

  8. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  10. This field is not part of the form submission.