CENTRAL Hub Volunteer Signup Form 2012

Thank you for volunteering to work Serving The City As One 2012.
You are filling out the volunteer form for the CENTRAL Hub.
If this is not the correct hub, select (Cancel) at the bottom of this page.

Please fill out one form PER PERSON, not per family.

All information collected on this form will be used only for Serving The City As One and will be kept private.

Fill out the PRIMARY EMAIL ADDRESS field to receive an email confirmation of your submission.

*First Name:

*Last Name:

*City:

*State:

*Primary Phone:

- - x

Secondary Phone:

- - x

Best Time To Call:

Primary Email
Address:

Secondary Email
Address:

Please review the project list and choose at least a 1st choice, optionally a 2nd and 3rd choice. Please put a check in the box of your choice(s).

I can work any
project needed:

1

2

3

Lakewood School
Projects:

1

2

3

Hospital Handout:

1

2

3

Yard Work:

1

2

3

Environmental
Projects:

1

2

3

Packing Projects:

1

2

3

Goodie Delivery -
Visitation:

1

2

3

Construction
Projects:

1

2

3

Sewing Projects:

1

2

3

Free Car Wash:

1

2

3

Letter Writing:

1

2

3

Music Projects:

1

2

3

Prayer Projects:

1

2

3

Audio Visual Mission:

1

2

3

Choose Life:

1

2

3

Downtown Rescue
Mission:

1

2

3

Salvation Army:

1

2

3

Lincoln School:

1

2

3

National Children's
Advocary Center:

1

2

3

305 8th Street:

1

2

3

Manna House:

1

2

3

Blount House:

1

2

3

Lunch is provided by the hub at no cost if you desire. Check with your hub for lunch location.

*Lunch 11:30 - 1pm:

Yes

No

If needed please select the T-shirt(s) you want by putting a check in the appropriate box.

Adult Shirts:

Childrens Shirts:

Sm

Med

Please Comment If
You Have Special
Needs:

(chars left: 500)

*Release Form -
Required:

Yes

No

Please read and check box that the participant (or parent/guardian if participant is a minor) acknowledges and accepts the risks of physical injury associated with participation in Serving the City as ONE April 21, 2012. The participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. The participant (or parent/guardian) promises to hold harmless the sponsoring organizations and their representatives for any injury related to the activity. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable arbitration process. The participant (or parent/guardian) gives permission to be photographed or have video taken by Serving the City volunteers and for pictures and video to be used in publicity about Serving the City in churches only.

Thank you for volunteering to work Serving The City As One 2012. You are filling out the volunteer form for the CENTRAL Hub. If this is not the correct hub, select (Cancel) at the bottom of this page.

Thank you for volunteering to work Serving The City As One 2012.
You are filling out the volunteer form for the CENTRAL Hub.
If this is not the correct hub, select (Cancel) at the bottom of this page.