Wabash Sampling Blitz
Registration

Do you have a volunteer partner? (Only one registration is needed per sampling team!)

Yes No

Are you willing to sample with someone you don't know that needs a sampling partner?

Yes No

Partner Name(s) ("N/A" if you do not have a sampling partner)

Partner Email(s) ("N/A" if you do not have a sampling partner)

Partner's Phone Number ("000" if you do not have a sampling partner)

Do you or your partner have a vehicle for sampling? If you do not, you will be placed with another person that does have a car.

Yes No

Sampling date and time?
You will sample on the same day that you pick up your supplies. Please indicate your anticipated arrival time so that we know when to expect you. If this needs to change later, just send us an email.

Friday Morning (April 24, pick up at Lilly Nature Center between 9am-noon) Friday Afternoon (April 24, pick up at Lilly Nature Center between noon-2pm) Saturday Morning (April 25, pick up at Mar Len Park between 9am-noon) Saturday Afternoon (April 25, pick up at Mar Len Park between noon-2pm)

Do you need to borrow a pair of waders?
Only one member of your group will receive a pair of waders. If you or your partner has tall boots or waders, then please select no. If no one in your group has boots/waders, please select yes and indicate your shoe sizes in the next question so we can lend you a pair.

Yes No

Shoe Size
(If multiple people in group, please enter everyone's shoe size and we will assign one pair to your group depending on availability)

Alternate Sampling Date
If the date you signed up for fills up, are you available to sample on the other day?

Yes - I can change sampling dates if needed No - I'm only available on the date I signed up for

Liability Waiver: In consideration of the privilege of my voluntary participation and the participation of any minors or wards for whom I am responsible in the Wabash River Sampling Blitz, I, FOR MYSELF AND MY HEIRS, REPRESENTATIVES AND ASSIGNS, HEREBY RELEASE, FOREVER DISCHARGE INDEMNIFY AND HOLD HARMLESS Wabash River Enhancement Corporation, Purdue University, the City of Lafayette, the City of West Lafayette, Tippecanoe County, and the Tippecanoe County Soil and Water Conservation District and all event sponsors and their respective Boards, officers, agents, employees, and representatives (the “Released Parties”) and any person or entity acting on behalf of a Released Party from any and all responsibility or liability for injuries or damages (including attorney’s fees and court costs) which the Released Parties may incur arising out of or in any way related to the negligence of the Released Parties or in connection with such claims or in connection with any judicial, quasi-judicial or administrative proceedings relating thereto resulting from or arising out of my participation and the participation of any minors or wards for whom I am responsible in the Wabash River Sampling Blitz. I recognize and fully understand that working in or around a body of water can be a dangerous activity. There can be hidden obstacles in the water, dangerous currents, sudden weather changes and, due to the whims of nature, any number of other hazards including the actions of other participants, all beyond the control of event organizers; that my voluntary participation and the participation of any minors or wards for whom I am responsible in such activities involves a risk of injury and even death and that I, for myself and any minors or wards for whom I am responsible am voluntarily participating in these activities with knowledge of the dangers involved. I acknowledge that the Released Parties, even if present, will not be monitoring me or my activities, and I HEREBY ON BEHALF OF MYSELF AND ANY MINORS OR WARDS FOR WHICH I AM RESPONSIBLE EXPRESSLY AGREE TO ASSUME AND ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH.

I have read the event waiver of liability and assumption of risk, and I am signing acceptance on behalf of myself and participating minors or wards for whom I am responsible.

Wabash Sampling Blitz
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Wabash Sampling Blitz
Registration