Volunteer Form

Volunteer Form
Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Email*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Background
College/School
Department/Field
Occupation
Company
Department/Position
In which areas would you like to volunteer?*
Skills/ Areas of Interest:
Do you have any volunteering experience? If yes, please describe.
Select your available days*

MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays

Volunteer Waiver & Authorization
I request to participate on a voluntary basis in the Nurture House Group program. In consideration for the opportunity to participate in Nurture House Group, I fully release and forever discharge Nurture House Group, all other Nurture House Group participants, and the members, officials and employees from all rights, claims and actions that I and my children now have or may have against Nurture House Group, all Nurture House Group participants, and the members, officials and employees of each, arising out of my participation as a volunteer in Nurture House Group. This release is intended to release all claims that I may have against Nurture House Group, all other Nurture House Group participants, the members, officials and employees, for liability for injuries, damages or losses to my person and or property, real or personal, whether known, unknown, foreseen or unforeseen.

In addition, I hereby specifically authorize and permit Nurture House Group to use my name and photographs, images and/or video of myself, for news releases, publications, websites and social media and for any lawful purpose.

On behalf of myself, I am freely and voluntarily executing this WAIVER & AUTHORIZATION after being apprised of all relevant information by Nurture House Group. In executing this release, I am not relying on any inducements, promises, or representations made by Nurture House Group or its members, volunteers, officers or directors.
Date

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Should be Empty:

Volunteer Form

Educational Background

Occupation

Volunteer Waiver & Authorization