Register for PurePactola: A Dam Good Swim! Volunteer - Job: Safety Boats

Please complete the registration form below to be considered as a volunteer for this event. You will receive a confirmation email if you are assigned as a volunteer.

Registration Information

Please enter your information into the fields below. Required fields are marked with *.

*First Name:
*Last Name:
*Date of Birth:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923
*Secondary Phone:
*Email:
*Confirm Email:
*Shirt Size:	Extra Small Small Medium Large Extra Large XX Large 3x 4x

Alternate Job Preferences

Alternate Job Preference #1:	Check-in Table & General Help Crowd Management Safety Kayaker Safety Lookout
Alternate Job Preference #2:	Check-in Table & General Help Crowd Management Safety Kayaker Safety Lookout

Additional Volunteers

If you are bringing a group of friends or volunteers but they are not registering through this system, please advise how many:

Number of volunteers:

Registration Waiver

Please Read Carefully. I understand that my participation in the 2023 Pure Pactola swimming event as a race volunteer is potentially dangerous and carries the risk of injury or death. By my voluntary participation, I state that I am physically able to participate and do so voluntarily, assuming all possible risks of every nature, including the negligence of the event organizers. In consideration for being allowed to participate, I, on behalf of myself as well as my heirs, hereby expressly waive and entirely release any claim of any nature against the event organizer, Active Black Hills, LLC, its members and any other person or entity arising from my voluntary participation in this event, and expressly agree to hold these released parties entirely harmless from any demands, claims, suits or causes of action, including reasonable attorneys fees brought about in defense of the same. I ACKNOWLEDGE THAT THIS IS A WAIVER OF LEGAL RIGHTS

* I fully understand and accept all conditions in this waiver.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

• I have read, have understood, and do accept the agreement above.
• I understand that this is a legal document with effects that I approve and authorize.
• The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
• I am authorized to agree to the terms of this document on behalf of the registrant.
• If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

• *Signature:

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You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 6:33:27 PM EDT on 6/2/2023.
Click here to print the agreement.