I understand that by submitting this form I am registering for VCHSS Community Connections programs and services. My participation is voluntary and I may register or withdraw at any time. I understand that there will be no charge for my participation or withdrawal.

I understand that VCHSS staff or volunteers deliver and facilitate the Community Connections programs. I agree to follow Community Connections policies. I will treat staff and volunteers respectfully. I accept all inherent risk and will not hold VCHSS liable for any damage or injury sustained resulting from my participation. I agree that those involved in the administration of Community Connections programming may share my contact information solely with those directly related to the programs and services in which I am participating. I consent to my image being shared in the VCHSS newsletter, website, and social media.