Join SIMBuddies Volunteer Community! Personal InformationFirst Name *Last Name *Email *Contact Number *X (Twitter) handle (if available)Gender *Select GenderMaleFemalePrefer not to sayAge GroupSelect Age Bracket18-2425-2930-3536-4041-45Date of birth *MonthSelect monthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year20072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979Select State *SelectRiversVolunteer Path *select pathClean Air /Zero SLCPs ProgramRecycling ProgramEcosystem Conservation ProgramEnergy Efficiency ProgramWaste Oil Management ProgramWEEE Program (Waste on Electrical and Electronic Equipment)Noise Pollution ProgramEcotourism ProgramWASH ProgramE-mobility / EV ProgramClean Energy ProgramWetland Protection and Oceans Conservation ProgramClimate Justice ProgramEcolabel Activation ProgramSustainable Agriculture ProgramClean Cook Stoves ProgramECO2RUPPERS Program Volunteer Consent FormProgram Description: The ECO2RUPPERS Program is dedicated to promoting sustainability and community engagement through various activities, including clean-up events, tree planting, recycling drives, educational workshops, advocacy and awareness events, etc. As a volunteer, you will play a crucial role in supporting these efforts and making a positive impact on the environment and your community. Volunteer Agreement: By signing this consent form, you agree to the following terms and conditions: Participation: - I understand that my participation in the Community Green Impact Program is voluntary. - I agree to follow all instructions and guidelines provided by program coordinators and supervisors. Safety: - I acknowledge that I am responsible for my own safety and well-being while participating in program activities. - I agree to use any provided safety equipment and adhere to safety protocols. - I will promptly report any injuries or safety concerns to program coordinators. Conduct: - I will conduct myself in a respectful and responsible manner at all times. - I will respect the rights and property of others and act in a manner that promotes a positive and inclusive environment. Confidentiality: - I understand that I may have access to confidential information related to the program or its participants. - I agree to maintain the confidentiality of such information and not disclose it to unauthorized individuals. Media Release: - I give my consent for ECO2RUPPERS to capture and use photographs, videos, or other media recordings of me during program activities for promotional and educational purposes. I understand that these materials may be used in print, online, or social media platforms. Liability Waiver: - I release and hold harmless the ECO2RUPPERS Program, its organizers, partners, sponsors and volunteers from any and all liability, claims, injury, loss or damages that may arise from my participation in program activities. Medical Treatment: - In the event of an emergency, I authorize the program coordinators to seek medical treatment on my behalf.Consent *I have read and understood the above terms and conditions and AGREE to participate in the ECO2RUPPERS Program as a volunteer.Volunteer Verification InformationNational Identification Number *Last 4 Digits of your Identification Number *Your Unique Volunteer ID Number would be generated with this.0 / 4Name of Referee *Referee Address *CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweReferee Contact Phone Number *Additional Volunteer InformationWho would you like us to contact on your behalf, in case of an emergency?Emergency Contact Name *Emergency Contact Phone Number *Password *Confirm Password * Submit