Fairchild BioTECH Student Volunteer Application Form
We appreciate your interest in becoming a Fairchild Tropical Botanic Garden BioTECH Volunteer. Please complete this application form and click the submit button at the bottom of the page. If you are under the age of 18, your application must include a parent/guardian signature.
Thank you!
Contact Information
First name:
*
Last name:
*
Address Line 1:
*
Address Line 2:
Address Line 3:
City:
*
State:
Choose
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UAE
UT
VA
VT
WA
WI
WV
WY
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Zip:
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Primary phone:
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Alternate phone:
Email address:
*
Demographic Information
It is used only to help us get a better idea of the demographic make-up of our volunteers.
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
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Sep
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Nov
Dec
Day
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Year
2022
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1917
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Student?:
Choose
Archimedian Upper Academy
Belen Jesuit High School
BioTECH High School
Carrollton School
Christopher Columbus High School
Coral Gables High
Coral Park Senior High
Coral Reef High School
Cutler Bay Senior High
DASH High School
Doral Academy Charter
Felix Varela High School
Florida International University
G. Holmes Broddock Senior High
Gulliver Prep
John A. Ferguson HS
Johnson & Wales
MAST Academy
Mater Academy Charter High
Miami Dade College
Miami Palmetto Senior High
Miami Sunset High School
New World School of the Arts
OTHER
Our Lady of Lourdes Academy
Ransom Everglades
Riviera Preparatory School
School for Advanced Studies
South Miami Senior High
TERRA High School
University of Florida
University of Miami
Major/Area of Study:
Please indicate if you are a Freshman, Sophomore, Junior or Senior.
Medical Considerations
Please let us know if you have existing medical conditions, allergies or other physical limitations that need to be considered when we are planning your volunteer work.
Emergency Contact
Please enter at least one contact phone number.
First name:
*
Last name:
*
Primary phone:
*
Alternative phone:
Email address:
Relationship:
Choose
Aunt/Uncle
Boyfriend/Girlfriend
Classmate
Colleague/Coworker
Cousin
Daughter / Son
Domestic Partner
Ex-spouse
Family Member
Fiance(e)
Friend
Godfather/mother
Granddaughter/son
Guardian
Housemate
In-Law
Neighbor
Niece/Nephew
Other
Parent
Partner
Physician
Sibling
Significant Other
Spouse
Stepdaughter/son
Stepfather/mother
Supervisor
*
Parental Consent - Electronic Signature
I consent to the participation of my son/daughter
in the Fairchild Tropical Botanic Garden volunteer program. I authorize the emergency treatment of my son/daughter if he/she is injured or becomes ill, if the staff supervisor is unable to contact me for permission to treat, or if the situation is deemed to be life-threatening. I certify that the information about my son/daughters physical limitations, allergies and medical conditions are correctly noted on this application. I am responsible for transportation arrangements for the applicant both to and from Fairchild. I also give permission to use any photographs that are taken of my son/daughter while he/she is volunteering at Fairchild for use in publicity or promotion without limitation or reservation.
Please type: Your name The date Relationship to the applicant Your primary contact phone number
Electronic Signature
I certify that the information given in this volunteer application is true and correct.
Please type your name and the date.
Hold Harmless
I fully and absolutely assume all risk of injury to myself or to my son/daughter (if parent signing for student volunteer), including, but not limited to death, and hereby unconditionally and absolutely release, even for their own negligence, indemnify and hold harmless Fairchild Tropical Botanic Garden and their officers and directors, employees, agents, representatives, and their insurers from all claims for damage or injuries of any kind to me or my son/daughter, now or in the future, arising from my participation as a volunteer in Fairchild Tropical Botanic Garden programs.
Further, I confirm that I or my son/daughter is in good physical health and represent that I or my child have no existing physical disability, illness or condition of any type that might be aggravated by the participation in said programs.
I have read this Hold Harmless Agreement and understand that it is an absolute release and I execute the same freely and voluntarily and accept and agree to its terms and conditions.
I Agree