MADISON 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 MADISON Hub.
If this is not the correct hub, select (Cancel) at the bottom of this page.

Please fill out one form PER FAMILY.

Please list the name(s) and age(s) of all children under 18 in the comments section below.

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:

*CHURCH:

*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

BLOCK PARTIES

Food Prep and
Service:

1

2

3

Local Assisted
Living Facilities:

1

2

3

Nursing homes,
apartment complexes:

1

2

3

Share Music or
Conversation:

1

2

3

COMMUNITY BLOCK PARTY

Food Prep and
Service:

1

2

3

Worship music,
vocals:

1

2

3

Friendly Contacts:

1

2

3

CONSTRUCTION PROJECTS

Home Maintenance and
Repairs:

1

2

3

Wheelchair Ramps:

1

2

3

Painting:

1

2

3

Plumbing Repairs:

1

2

3

ENVIRONMENTAL PROJECTS

Clean up parks,
schools, greenways:

1

2

3

Work for Madison
Beautification Board:

1

2

3

Mulching
Neighborhood Parks:

1

2

3

Planting Trees:

1

2

3

Community Garden:

1

2

3

IN-HOUSE PROJECTS

Food Prep and
Cleanup:

1

2

3

Letter / Card
Writing:

1

2

3

Sewing Projects:

1

2

3

Packing Projects:

1

2

3

MINISTRY AND AGENCY WORK

Cleaning:

1

2

3

Painting:

1

2

3

Sorting:

1

2

3

Moving:

1

2

3

Spend Time with
Special Guests:

1

2

3

Prayer Leaders and
Walkers:

1

2

3

SERVANT PROJECTS

Community Giveaways:

1

2

3

Cleanup and Service
at Local Thrift
Stores and Madison
Hospital:

1

2

3

Car Wash:

1

2

3

Window Cleaning:

1

2

3

SPECIAL PRE-DAY
BAKING -- HOME
PROJECT:

1

2

3

Breakfast is provided at no cost at CrossPointe Church.

*Breakfast (7:15 AM):

Yes

No

If needed please select the T-shirt(s) you want ($5 each) by putting a check in the appropriate box.

Adult Shirts:

Childrens Shirts:

Sm

Med

Please Comment If
You Have Special
Needs. Also, list
CHILDREN under 18
name and age here:

(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 MADISON 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 MADISON Hub.
If this is not the correct hub, select (Cancel) at the bottom of this page.