Print the volunteer form and either mail or drop it off at Hebron Realty at 108 South Main Street.
Rebuilding Together Hebron
2016 Volunteer Application
April 30, 2016 Workday
I would like to participate in Rebuilding Together Hebron.
Name _________________________________________ Age _________
(you must be at least 14 years of age)
Home address _________________________________________________
City, State, and Zip _____________________________________________
Phone number _______________ Email address ____________________
Are you a high school student? __________
Do you have a request to work with a friend or relative on the same project?
Name or project ______________________________________________
Skilled: trained tradesman Unskilled: performs when needed, not a professional
Please check any that apply
Skilled Unskilled Skilled Unskilled
Painting _____ _____ Carpentry _____ _____
Drywall hanging _____ _____ Electrical _____ _____
Fencing _____ _____ Roofing _____ _____
Heating / AC _____ _____ Laying floor tile_____ _____
Carpet laying _____ _____ Plumbing _____ _____
Clearing / yard work _____ _____ Other ________________________
I am interested in volunteering on the following committees:
______ Food Committee ______ Publicity Committee ______ House Captain ______ Fundraising Committee ______ Event Day Registration
On Saturday, April 30, 2016 meet at 7 am at The Gathering Place, 131 N. Main in Hebron
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Please complete the Waiver of Liability
WAIVER OF RIGHTS AND CLAIMS BY REBUILDING TOGETHER VOLUNTEER PARTICIPANT
The undersigned individual intends to participate as a volunteer in repair projects sponsored by Rebuilding Together Hebron, a nonprofit corporation, and will receive no compensation or remuneration for services.
Rebuilding Together Hebron does not provide workers compensation insurance for participants. Therefore, in recognition of the above and in consideration of the opportunity afforded to participate in Rebuilding Together Hebron projects, the undersigned hereby waives any and all rights to any and all claims, causes of action, demands, or damages of any kind or nature whatsoever for liability from injury to my property or person, or the property or persons of my employees or dependents, whether known or unknown, foreseen or unforeseen, existing, claimed to exist, or which can ever hereafter arise against Rebuilding Together Hebron, and Rebuilding Together, Inc. or its officers and directors collectively or individually. employees, successors, or assigns.
Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damage to my property sustained in connection with my activities for the Rebuilding Together Hebron projects.
I further consent to the unrestricted use by Rebuilding Together Hebron and/or any persons authorized by them of any photographs, recordings, interviews, videotapes, motion pictures or auditory recordings of me or my dependents created in connection with the project. Images may be used on social media outreach.
______I have read and agree to the disclaimer.
______I have read and understand the foregoing waiver of rights and claims and agree to abide by the terms and conditions thereof. By signing this agreement, I certify that I am 18 years of age or older or that I have attached the consent of my parent or legal guardian.
Guardian Consent Form
This guardian consent form must be completed for all volunteers between the ages of 14 and 17 in addition to the Waiver of Rights and Claims by Rebuilding Together Hebron Volunteer Participant.
Name of Minor (Please Print)______________________________________________
I represent and warrant to Rebuilding Together Hebron that I am the parent or guardian of the minor named above. The above-mentioned minor has my permission to participate in
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the Rebuilding Together Hebron project. On behalf of such minor and myself, I hereby agree to all of the terms and conditions of the Waiver of Rights and Claims by Rebuilding Together Hebron Volunteer Participant.
In case of medical or dental emergency, I request that Rebuilding Together Hebron attempt to contact me at the phone number listed below. However, I hereby give my permission to the physician selected by Rebuilding Together Hebron to hospitalize, treat, secure proper treatment for, and order injections, anesthesia or surgery for the minor named above. A copy of this permission form may be accepted and treated by the physician as equivalent to the original form.
I (we) agree to the Parental Waiver ________
Name of Parent/s________________________________________________________