Personal Information:

Personal / Professional References

Reference 1

Reference 2

Reference 3

Emergency Contact Information

Areas of Interest

Photo and Press Release

I do hereby give the Solid Waste Authority of Palm Beach County, their assign, licenses and legal representatives the irrevocable right to use my name (or any fictional name), picture, portrait, photograph, visual and voice recording and likeness in all forms and media and in all manners, including photo, film, audio, video and all social media representations, for nonprofit, public purposes, and I waive any right to inspect or approve the finished product, including written copy that may be created in connection therewith.

Please sign below, if you are under the age of 18 please have a parent or guardian sign instead.

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"Volunteers of governmental agencies are entitled to workers compensation and are subject to the same limitaions as an employee."