City Serve 2019 Project Form

PROJECT SIGN UP

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Select Project *

Are you serving as part of a group? *

Yes No

What is the name of your group/church? *

T-Shirt Size (Please note: T-Shirts are distributed on a first come, first serve basis at the Kickoff.) *

Serving as a family? You can list additional family members here with their t-shirt sizes. *

Please do not use this space to list other members of your church/small group/etc.

Are you interested in serving as a team leader? Team Leads will oversee projects and be responsible for connecting with the project contact person one week prior to City Serve. *

Yes! No, thanks!

LIABILITY DISCLAIMER: In accordance with the spirit of volunteerism and service, I, the undersigned, assume full and complete responsibility for any injury or accident that may occur to me during my voluntary participation in the 2018 City Serve activities. Therefore, I hereby release, indemnify, and hold harmless Love INC of Benton County, the organizers, the agency or project site at which I volunteer and sponsors and supervisors of all activities from any and all liability in connection with any injury (including any injury caused by negligence), in conjunction with volunteer activity on Saturday, May 5, 2018. I acknowledge that there are certain foreseeable and unforeseeable risks associated with participating in this event, including, but not limited to, illness, traveling to and from the event, and the effects of the weather, all such risks being understood and appreciated by me.

By checking this box, I agree to the liability disclaimer. *

Agree

COMMUNICATIONS RELEASE: I hereby assign the rights for the video and /or photographic recording(s) made of me on Saturday, May 5, 2018 participating in volunteer activity by Love INC of Benton County or its partner agencies. I hereby authorize the editing, duplication, reproduction, copyright, exhibition, broadcast and or nonprofit use and distribution of said recordings for purposes deemed suitable by Love INC of Benton County. I hereby waive any right to approve the finished products.

Do you agree to the communications release? *

Agree Do not agree