Eco2rupper Volunteer Personal InformationFirst Name *Last Name *Email *Contact Number *Twitter handle (if available)Gender *Select GenderMaleFemalePrefer not to sayAge GroupSelect Age Bracket18-2425-2930-3536-4041-45Date of birth *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year2006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979Select State *Select Your StateAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguFCT - AbujaGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraLGA (Your Local Government Area) *Volunteer Path *Select Volunteer PathYouth DevelopmentDisability InclusionInnovation & IndustrializationClean EnergyClimate ActionWASH (Water, Sanitation& Hygiene)Humanitarian ActionEnterprise Development & Job CreationJustice & Human Rights ProtectionGender-based Violence EliminationInclusive Blue Economy DevelopmentJust Green Transition (Green Economy Inclusion)Inclusive Digital Transformation (Digital Economy Inclusion)Sustainable Democracy (Civic Participation & Engagement)Unity & Cultural IntegrationRepresentational Equity (Women in Leadership)Food SecurityHealth & WellbeingPeace & SecurityEqual Education OutcomesECO2RUPPERS Program Volunteer Consent FormProgram Description: The ECO2RUPPERS Program is dedicated to promoting sustainability and community engagement through various activities, including clean-up events, tree planting, recycling drives, educational workshops, advocacy and awareness events, etc. As a volunteer, you will play a crucial role in supporting these efforts and making a positive impact on the environment and your community. Volunteer Agreement: By signing this consent form, you agree to the following terms and conditions: Participation: - I understand that my participation in the Community Green Impact Program is voluntary. - I agree to follow all instructions and guidelines provided by program coordinators and supervisors. Safety: - I acknowledge that I am responsible for my own safety and well-being while participating in program activities. - I agree to use any provided safety equipment and adhere to safety protocols. - I will promptly report any injuries or safety concerns to program coordinators. Conduct: - I will conduct myself in a respectful and responsible manner at all times. - I will respect the rights and property of others and act in a manner that promotes a positive and inclusive environment. Confidentiality: - I understand that I may have access to confidential information related to the program or its participants. - I agree to maintain the confidentiality of such information and not disclose it to unauthorized individuals. Media Release: - I give my consent for ECO2RUPPERS to capture and use photographs, videos, or other media recordings of me during program activities for promotional and educational purposes. I understand that these materials may be used in print, online, or social media platforms. Liability Waiver: - I release and hold harmless the ECO2RUPPERS Program, its organizers, partners, sponsors and volunteers from any and all liability, claims, injury, loss or damages that may arise from my participation in program activities. Medical Treatment: - In the event of an emergency, I authorize the program coordinators to seek medical treatment on my behalf.Consent *I have read and understood the above terms and conditions and AGREE to participate in the ECO2RUPPERS Program as a volunteer.Volunteer Verification InformationNIN *Last 4 Digits of your NIN *Your Unique Volunteer ID Number would be generated with this.0 / 4Name of Referee *Referee Address *CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweReferee Contact Phone Number *Additional Volunteer InformationWho would you like us to contact on your behalf, in case of an emergency?Emergency Contact Name *Emergency Contact Phone Number *Password *Confirm Password * Submit