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Packing Volunteer Form

By completing this form you agree to the following hold harmless & waiver and permission to use photograph:

In order to participate as a vendor, volunteer, or exhibitor at the HLD Beale Ave (formerly Butterick), I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin do hereby release, indemnify, and hold harmless HLD Beale Ave, Blair Companies Real Estate, Blair Companies, and their respective officers, officials, agents, and/or employees, from any and all liability, including but not limited to; injury, disability, death, loss, or damage to or destruction of personal property, and any and all costs of defense including attorney fees.

I acknowledge, understand, and agree that I have read this release of liability and assume any and all risks associated with using the facilities provided and that I sign this release and waiver of liability voluntarily and without inducement.

I grant Blair County Community Action, its representatives, and employees the right to take photographs of me, my children, or my property in connection with the above-identified subject.

I authorize Blair County Community Action, its assigns, and transferees to copyright, use, and publish the same in print and/or electronically. I agree that Blair County Community Action may use such photographs of me, or my children, with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

Children 8 years and up are welcome to volunteer for packing, this form must be completed by a guardian. Children under 8 years old may come to a packing event but are unable to volunteer.

*If you are volunteering as part of a group, each member of your group needs to complete this form.

* If under 18 years of age, parent or guardian must sign.

In the event of schedule changes, announcements will be made on the Mountain Lion BackPack Program Facebook page and all group leaders will be notified.  This schedule will only change in the event of changes to the school calendar from the school district or inclement weather.


If you have any questions, please contact us at 814-946-3651 or via email:

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