Community Resource Group
Participant sign up, release, and consent form

Partners in Diversity (PID) sponsors a series of Community Resource Groups (CRGs) to build community and facilitate connection across traditionally underrepresented demographic groups, and to serve the unique needs of members for learning, support, and shared lived experiences. The intent of these CRGs is to support individual members within a CRG in order to advance the community as a whole. Through the CRGs, PID aims to:
  • Host a welcoming space among those who identify as members of a particular community, especially member professionals who are new to the region.
  • Support individual professional development for community members, particularly those from traditionally underrepresented populations within the regional workforce.
  • Gain insight into the perspectives and needs of community members to help inform PID’s strategic agenda.
Participants of the CRGs must live in Oregon or southwest Washington (Clark, Cowlitz, Skamania counties) and must self-identify with a particular demographic group served by that CRG.

Question Title

* 1. General Information

Question Title

* 2. Employer

Question Title

* 3. Position / Job Title

Question Title

* 4. Race/ethnicity (check all that apply)

Question Title

* 5. Which Community Resource Group do you wish to participate in:

Question Title

* 6. How did you hear about us?

Acknowledgement and Release

I understand that my participation in the Community Resource Group (CRG) organized by Partners in Diversity (PID) is voluntary.  I assume any risk associated with participating in any event organized by PID through the CRG, and release PID and its employees, officers, directors, and representatives, including but not limited to CRG leaders and members, from any and all claims, causes of action, damages, losses, or liabilities of any kind related to, or arising as a result of my participation in any CRG event, including but not limited to claims for attorneys’ fees, personal injury, or property loss or damage.

Right of Publicity Consent

I understand that in connection with my participation in the CRG or CRG events, I may be photographed or my image or voice captured on audio or video recording.  I agree to allow such photographs, videos, films, or other recordings of me and my image, likeness, voice, and name to be used by PID for any purpose, including for commercial and publicity purposes, in any media, including on social media.

Question Title

* 7. By typing my name below and clicking the “DONE” button, I am signing this agreement.  I agree this form signed and delivered by digital / electronic means has the same legal effect as a manual/handwritten signature.

T