The King's Table Volunteer Registration Form

Volunteer Registration

The King's Table ("TKT") is open every Saturday 10a-12p. Volunteer call time of 8:30a is strictly enforced. The Volunteer Check-In Station will close by 9:15a. If you cannot make it by that time, please plan to volunteer with us another time. Volunteers are also needed for TKT food box assembly Tuesdays - Fridays, 10a-5p and Tuesday evenings, 6p-9p. Please complete a separate registration for each day that you are volunteering. Anytime within these hours is greatly appreciated.
Documentation of COVID Testing within 14 days prior to serving is required for all volunteers on the New Birth campus. Please bring your NEGATIVE test results with you when you come to serve at The King’s Table. Note: If you have received the complete Covid-19 vaccine shot(s), you may bring your vaccination card in lieu of test results, although we strongly encourage regular testing. COVID Testing Sites: The Department of Public Health has a list of sites available at https://dph.georgia.gov/covidtesting Rapid testing is available at some CVS and Walgreens
Date You Are Volunteering to Serve*

MonthDayYear
Date
Area Where You Will Serve*
Full Name*

First NameLast Name
Address*

Street Address

County

CityState

Zip Code
County of Residence*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Name of NB Ministry Currently Serving or Organization Name*
Have you completed the COVID-19 vaccination shot(s)? (Answer yes if you have had 2 shots for Pfizer & Moderna, 1 shot for Johnson & Johnson)

YesNo
Date of Last Dose

MonthDayYear
Date
All volunteers are welcome to receive a food box at the end of serving day (maximum of 2 per person). How many boxes of food would you like? (If 0, skip to "Next". If 1 or 2, please answer the following questions.)
All volunteers are welcome to receive a food box at the end of serving day. How many boxes of food would you like? (If 0, skip to Next. If 1 or 2, please answer the following questions.)

012
How many HOUSEHOLDS are you getting boxes for this week?
How many HOUSEHOLDS are you getting boxes for this week?
TOTAL # of people in the household(s)?
TOTAL # of Children (age 17 & under):
TOTAL # of Seniors (age 60 & over):
TOTAL # of Adults (age 18-59):
# of Children (age 17 & under):
# of Adults
# of Seniors (age 60 & over):

VOLUNTEER RELEASE & WAVIER OF LIABILITY FORM COVID-19 (2021) Waiver of Liability The below name volunteer, for itself and its officers, employees, contractors, heirs, executors, administrators and assigns, hereby releases, waives, discharges and holds harmless, NBMBC and its successors, directors, officers, employees, successors, assigns, insurers, members and agents from any and all liabilities, claims and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services provides to NBMBC, including, but not limited to, any third party claim. I further understand and acknowledge that this Release discharges NBMBC, its officers, employees, contractors, successors, assigns, insurers, members, and agents from any liability or claim that it may have against NBMBC with respect to bodily injury, personal injury, illness, death, property damage, or any other claim that may result from my services or participation provided to NBMBC. Confidentiality By signing below in consideration of my volunteering with New Birth Missionary Baptist Church, Inc. (hereinafter referred to as “New Birth”), do hereby agree that any information I receive concerning New Birth during the course of my volunteering whether printed, written, or oral, shall be held in confidence and not revealed either directly or indirectly, in whole or part, to any other person, firm, or organization and I agree not to use such confidential information for my personal advantage or that of any third party. Further, I understand and agree that New Birth will have the right to discontinue my volunteer service, bring a restraining order or if necessary bring other legal action against me and obtain costs and attorney’s fees, should I violate this Confidentiality Agreement. Upon the end of my volunteer services, I agree not to disclose either directly or indirectly, in whole or part, any information concerning New Birth which may have become known to me during the course of my volunteering. Medical Treatment: By signing below, I hereby release and forever discharges NBMBC from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered. I hereby understand the risks of COVID-19 and by signing below assume all liability arising from my participation in testing, food packaging, preparation and distribution. I full acknowledge the risk of my involvement and willingly choose to participate. Assumption of Risk: By signing below, I understand that the services provided to NBMBC may include activities that may be hazardous. I hereby expressly assume the risk of injury or harm from my participation in activities or programs held or hosted by NBMBC and release NBMBC from all liability forever. By signing below, I express an understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily. My signature further acknowledges and represents that I have read the foregoing in its entirety and understand it and by signing it on my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; if so, this written agreement supersedes all previous understandings and agreements between the parties, whether oral or written. By signing below, I attest I am at least eighteen (18) years of age and fully competent; and executes this release for full, adequate and complete consideration fully intending to be bound by the same. By signing below, I acknowledge that: I have received a negative COVID-19 test result within the last 7 days. I will provide proof of my negative test result when I check in to volunteer. I do not currently have any COVID-19 symptoms. I have not had any COVID-19 symptoms in the last 14 days. I have not come in contact with anyone with COVID-19 symptoms in the last 14 days. I have not traveled outside of the country in the last 14 days.
I have read and understand the Volunteer Release and Waiver of Liability.*

Yes
Printed Name*
Signature*

Clear
Date

MonthDayYear
Date
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