This registration MUST be completed by parents/adult and NOT youth/students:
HC DrugFree's medication and sharps collection is scheduled for Saturday, October 23 from 10 a.m. to 2 p.m. (with set up 9:30 a.m. and cleanup from 2:00 to 2:15 p.m.). Youth hold signs/arrows away from the collection site and are expected to wear masks and socially distance. Youth are NOT permitted to collect medication or sharps. Rain or shine, this is an outdoor event in the Wilde Lake Village Center parking lot. 

Please register each participant through their own individual form.

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* 1. Because we are so close to our event, please complete this registration and arrive at the time you select below. We will not confirm by email. Go to the volunteer table upon arrival. Thank you! See you on Saturday.
Student's first name

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* 2. Student's last name

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* 3. Age of youth/student

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* 4. New!!! Due to COVID concerns, an adult is to be with youth/students at this event. Will you or an adult you trust be with your student? If so, each adult MUST complete an adult registration using a different link. If not, we may decline your student's participation at this event.

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* 5. Parent's/guardian's first name

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* 6. Parent's/guardian's last name

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* 7. Parent's email address

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* 8. Re-enter email address

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* 9. Youth/student's email address

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* 10. Re-enter email address

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* 11. Emergency phone number

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* 12. Re-enter phone number

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* 13. List EXACT time between 9:30 a.m. and 2:15 p.m. youth/student wants to be with us. Our preference is to have the same students remain from 9:30 to 2:15 to limit students coming/going. We may decline volunteers not needed or if the time options are not best for HC DrugFree. Feel free to add comments for us to consider.

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* 14. Is youth/student willing to volunteer rain or shine? (Please be sure students dress for the weather.)

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* 15. Is youth/student willing/able to hold a sign 

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* 16. If youth/student is not able to stand or prefers to sit, will you provide your own lawn chair? (We will not provide chairs.)

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* 17. All volunteers are required to wear a mask, socially distance, and follow HC DrugFree's guidance and procedures based on CDC guidelines. Do you agree that you will explain this to your student and they will comply?

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* 18. Teens previously at our medication collection were given t-shirts and are expected to wear them and dress appropriately for the weather (rain or shine!). If it's cold, plan to layer UNDER the t-shirt so they can be seen. Due to COVID, we may not distribute any shirts at the event. Does your student have a shirt?

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* 19. Questions or additional information for HC DrugFree

By submitting this registration and as the parent and/or legal guardian of this youth/student, I agree to this waiver(s):

I have read this waiver and knowing the facts, I, for myself and anyone entitled to act on my behalf, waive and release HC DrugFree and its employees, directors, officers, partners, agents, and sponsors from and against all claims, demands or causes of actions for accidents, personal injury, bodily injury, death, property damage or other injury or loss or damage of any kind, occurring from any cause arising from or related to or in connection with named participant’s involvement in the event named above.

Further, I grant permission to all of the foregoing to use named participant’s photographs, audio and audio visual recordings or any other record of this event for any legitimate purpose.

I understand that it is my responsibility to IMMEDIATELY report any injury or concerns to HC DrugFree’s Executive Director or Board Member present at this event.

I agree to discuss the following with my youth/student: the importance of wearing a mask throughout this event, social distancing even outdoors, and proper hand sanitizing.
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