Expense/Reimbursement Report Form

Hello Friend

Thank you for offering your time to volunteer for Small Town Project. We really appreciate it, and wouldn't be able to do this without your help!

This is a quick form just to grab some details from you, particularly your contact details and availability.

We don't expect everyone to be available for every day but this will help us get a better understanding of your availability and how we can make the biggest impact in the community.

Thank you!

Today's Date

Date

Name*

First NameLast Name

E-mail*

Your E-mail Address

Mobile Number*

Please enter a valid phone number.

Opt-in to receive Text Reminders?*

YesNo

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Birthdate*

Date

Age

Parent/Guardian Name

First NameLast Name

Parent/Guardian Email

example@example.com

Parent/Guardian Phone

Please enter a valid phone number.

Parent/Guardian Birthdate

Date

What Programs are you Interested in Volunteering for?*

Rocky Ford Food ShareRocky Ford Youth InitiativeCommunity Clean Up Days or Special Events

What Days are you available to volunteer at the food pantry?

Tuesday (8 am -10 am)Tuesday (2 pm - 4 pm)Wednesday (10 am - 5 pm)Thursday (10 am - 3 pm)

Youth Program volunteers must be 14 years and older. Youth Program volunteers 18 years and older are required to complete a criminal background check and a child abuse and neglect records check. Our Youth Program Coordinator will follow up with you to complete these requirements prior to your start date.

What Days are you available to volunteer at the after school program?

Monday (4 pm-7 pm)Tuesday (4 pm-7 pm)Wednesday (4 pm-7 pm)Thursday (4 pm-7 pm)

Community Clean Up Days and Special Events are planned throughout the year. We will be sure to reach out to you when the next one is scheduled.

Tell us one or a few interesting facts about you to help us get to know you. *

(Ex: You love to crochet, you're an avid skydiver, you hate peas, etc.),

What is your shirt size? (You will receive a Small Town Project Volunteer t-shirt after 10 hours of volunteering).*

Volunteer Agreement

In consideration of being allowed to participate in any way in the program, related events, and activities. I the undersigned, acknowledge, appreciate, and agree that:

1. I am donating my time and services without any compensation and shall at no time be considered an employee or independent contractor of The Small Town Project. The risk of injury from the activities involved in this program may be significant, including the potential for permanent paralysis and death.

2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my participation.

3. I willingly agree to comply with the terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release indemnify, and hold harmless The Small Town Project, and its officers, agents and/or employees, other participants, sponsors, advertisers, partners, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any injury, disability or death I may suffer, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.

5. I grant to The Small Town Project, its representatives, and employees the right to take photographs at this event of me and of any minor participants for which I am the parent or guardian. I authorize The Small Town Project, its assigns, and transferees to use such photographs, with or without names, for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content, and to copyright, use, and publish the same in print and/or electronically.

I have read this release of liability and assumption of risk agreement, fully understand its terms, and understand that I have given up substantial rights by typing in my name to sign it, and I sign it freely and voluntarily without any inducement.

E-Signature*

If you have any questions you can contact the Small Town Project team by email at info@smalltownproject.org or by call/text at (719) 800.7277.

Small Town Project Volunteer Sign Up