SANDS Events Director: Dave Burgess
Email:
Phone: 402-559-3743 Mon. - Fri. 8-4
Mobile: 402-650-0211 After Hours
SANDS is a partnership between the Nebraska Game and Parks Commission and the Munroe-Meyers Institute-University of Nebraska Medical Center.

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You Are Visitor Number:
2638

SANDS Program

Sportsmen & Women Assisting the Nations's Disabled Sportsmen & Women

SANDS Project Input

Please complete the following form to request or offer assistance to the Nation's disabled sportsmen and women.

Last Name:	First Name:
Address:

City:

State:

County:

Phone:

Zip:

Email:

Action:
	Disabled sportsmen/women seeking assistance to participate in outdoor activities. Please enter the following information if you would like the opportunity to be contacted by other viewers of this site who may wish to offer the selected assistance.
	Sportsmen/women who wish to offer assistance to a disabled sportsman/woman. Please enter the following information if you would like to offer assistance and or be contacted by other viewers of this site.
	Public events available for sportsmen/women with disabilities. Please enter the following information if you or your organization would like to make available information for an event for sportsmen/women with disabilities.
	Notes from the field. Please enter the following information if you would like to highlight particular areas that offer greater access for sportsmen/women with disabilities. We hope to build a database that highlights areas across the state that provide greater outdoor opportunities for sportsmen/women with disabilities.
	Landowner Offer. Landowners wanting to offer assistance to disabled sportsmen and women.

Activity:

Assistance Offered/Needed:

SANDS Hold Harmless Agreement:

I hereby acknowledge the existence of, and assume full responsibility for, risks associated with my involvement in all activities through the SANDS program, which may include property damage, personal bodily injury and/or death. Furthermore, I herewith agree to indemnify and hold forever harmless the State of Nebraska, the Nebraska Game and Parks Commission, the University of Nebraska Medical Center, the Munroe-Meyer Institute, AmeriCorps and or SANDS, including their agents and employees, against loss from any claims, demands or actions arising from participation in SANDS activities, that may hereafter be made or brought against such parties. In addition, I have full knowledge of the proper techniques needed to participate safely in all activities and have the proper certifications required by law to engage in such activities.
					
I certify that all the information I have provided is current and accurate and I hereby agree to all terms, conditions and liability waivers that have been stated above for my participation in all SANDS activities. Additionally, I declare a comprehensive knowledge of needed safety techniques and hold the required certifications for participation.
					
As legal guardian of the above named, I hereby acknowledge and assume all the risks and liability due to the participation of my dependent in all SANDS activities. Furthermore, I agree to all terms, conditions and liability waivers that have been stated above for said dependent participation in SANDS.

I agree to the Hold Harmless Agreement above.