Gleaning

Form (Participant)
Gleaning Date: Sept 8, 2018
Name: _______________________________________________________________________________
Family Members Present: ________________________________________________________________
Street Address/PO Box: _________________________________________________________________
City: _______________________________ County: ________________ State: _____ Zip: ___________
Home Phone: ( ) ______- ____________ Cell Phone: ( )______-____________
Work Phone: ( )______-_____________ Email: ___________________________________________

Emergency Contact: _______________________________________
Relationship: _____________________________________________
Phone: __________________________________________________
Secondary Phone: _________________________________________

Release and Waiver of Liability, Assumption of Risk and Indemnity
Safety is of paramount importance in a gleaning event. For the protection of all involved, this disclaimer is
necessary.

I, for myself, for personal representatives, assigns, heirs and next of kin:

1. I acknowledge, agree, and represent that I understand the nature of gleaning activities and that I am qualified,
in good health, and in proper physical condition to participate in such an activity. I further agree and warrant that
if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in this activity.

2. I acknowledge that I have elected to participate in an activity that includes some risk of injury. I hereby release,
discharge, and covenant not to sue Roadrunner Food Bank (RRFB), New Mexico State University, Sandoval County
Extension, the Sandoval County Master gardeners, Seed2Need, its membership, their respective administrators,
directors, agents, officers, members, volunteers and employees, other participants, any sponsors, and owner and
lessors of premises on which the activity takes place (each considered one of the "releases" herein) from all
liability, claims, demands, losses, or damages on my account caused or alleged to be negligent rescue operations
and I further agree that if, despite this release and waiver of liability, assumption of risk and indemnity agreement
I, or anyone on my behalf, makes a claim against any of the Releases, I will indemnify, save and hold harmless each
of the releases from any litigation expenses, attorney fees, loss, liability, damage or cost which may incur as the
result of such claim.
Photo Release
Also, to encourage the continuation and expansion of gleaning events, I hereby give anyone involved with the
event, with the approval of RRFB or Seed2Need, the right and permission to copyright and/or use, reuse and/or
publish and/or republish pictures or images of me for the purpose of illustration, advertising and promoting
gleaning events and/or participants working with and supporting RRFB and Seed2Need in those events.

Children You are Signing For:

__________________________________________ ______ ________________________________________

__________________________________________ _______________________________________________

Signature: _____________________________________ ___________ _______________Date:______________
(Participant or Parent/Guardian for children under the age of 18)
Gleaning Rules:

1. Please sign gleaning waivers and photo releases before you harvest fruit.

2. Please respect the homeowner’s privacy and property. Do not pick fruit from trees that the homeowner has
designated for their personal use.

3. No one under the age of 16 is allowed to use the orchard ladders. There are plenty of long picking poles.

4. Picking poles can be heavy, particularly the long ones. Be aware of your surroundings so you don’t hit anyone.

5. We do not want to damage the trees or bruise the fruit so do not climb the trees or shake the fruit from the
branches.

6. Pick up all damaged fruit and branches and dispose of it in the containers provided

Enjoy yourself. You, your family and friends are helping feed hundreds of needy families in our community. Thank
you!