BlockWork Volunteer Application

This year's BlockWork project is spread out over two days:

- “Lowes Red Vest Day” Tuesday, October 19

- “Make a Difference Day” Saturday, October 23

Please select the time slot(s) that you are available to volunteer for tasks. Each slot is two hours, you can volunteer for as many or as few as meets your personal schedule.

Tuesday, October 19 - Time Slot(s)

8 - 10 a.m. 10 a.m. - noon noon - 2 p.m. 2 - 4 p.m. 4 - 6 p.m. (clean up)

Saturday, October 23 - Time Slot(s)

8 - 10 a.m. 10 a.m. - noon noon - 2 p.m. 2 - 4 p.m. 4 - 6 p.m. (clean up)

Please select the task(s) that you would prefer to be assigned. You can select as many or as few as you feel comfortable doing.

Select Task(s)

Volunteer waiver to participate in BlockWork 2021.

Volunteer deadline: October 15, 2021

I hereby, on behalf of the City of Salisbury, release indemnify and hold harmless its officers, directors, employees, agencies and the organizers, sponsors and supervisors of all activities, from any and all liability in connection with any loss claim or injury, unless caused by gross negligence or willful misconduct of the aforesaid; in conjunction with the BlockWork neighborhood improvement project, October 19 and/or October 23, 2021. The City of Salisbury has liability insurance which should cover accidents should one occur at the to-be-determined project site.

I likewise hold harmless from liability any person transporting a member of our organization or volunteers to or from any BlockWork activity. In addition, the City of Salisbury has permission to utilize any photographs or videos taken for publicity purposes.

I will follow guidelines related to Covid-19 in accordance with the Governor of the state of North Carolina.

Name *

First Name Middle Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

Email Address *

T-Shirt Size *

Your E-Signature *

Clear

Parent or Guardian's Signature if under 18 years of age

Clear

BlockWork 2021 Volunteer Form