CLCC Corporate and Group Volunteer Application

Corporate and Group Volunteer Application
Name of Business/Group*
Primary Leader*

First NameLast Name
E-mail*
Phone Number:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact *

First NameLast Name
Emergency Contact # *

Area CodePhone Number
Group Size*
Are any group participants under the age of 17?*

YesNo
Please identify the area of service your group is interested in.*

Collection DrivesMeal SponsorGrounds KeepingMobile Medical ClinicOther
Please list the preferred day, or dates, of service*
Indemnity and Hold Harmless
By submitting this application I hereby agree to hold harmless and indemnify The Foundry Ministries and/or any of its auxiliary or affiliated organizations from any and all claims, suits, causes of action and liability arising out of any claims, suits or causes of action of any kind which undersigned or his/her child may have from now henceforward arising out of any actions, activities or events sponsored by The Foundry and/or any of its auxiliary or affiliated organizations. This hold harmless and indemnity agreement extends to any acts and/or omissions engaged in by or attributable to any person or entity, including any agent, employee, volunteer or board member of The Foundry and/or any of its auxiliary or affiliated organizations. I realize that The Foundry will not be held responsible for any accident or injury that may occur while I am a volunteer. I also understand and agree that I may ask or be asked to end my volunteer service at any time, for any reason with sufficient notice. I will respect the confidentiality of all client information available to me through my position and maintain a professional relationship with all The Foundry staff and residents while I am a volunteer with this organization.*

I have read, understood, and accepted the Indemnity and Hold Harmless Agreement.
Media Release
I hereby irrevocably agree and consent that The Foundry Ministries may use all portions of recorded, videotaped, filmed, or photographed shots for promotion of The Foundry Ministries, Inc. I release all rights to media sources for use and resale by The Foundry Ministries as stock footage and other paying sources. The Foundry has the right to use my picture, silhouette, and other reproductions of my likeness and voice in connection with any advertising materials, theatrical distribution, broadcast, television, video, DVD, social media, and the Internet.*

I have read, understood, and accepted the Media Release Agreement.
Group Release
I am the designated group leader and assume all responsibilities for this group, its members, and its actions. I acknowledge that each aspect of release applies to each individual group participant as well as the group as a whole.*

I acknowledge that I have discussed, or will discuss, prior to my group's arrival all information included and given to me by Changed Lives Christian Center.
Group Roster
Please the first and last names of all members participating in your group.*
Once you submit your application, we will contact you shortly to connect you to an opportunity.

Thank you!
Should be Empty:

Corporate and Group Volunteer Application

Indemnity and Hold Harmless

Media Release

Group Release

Group Roster