My Release Volunteer Registration
A SAFE SPACE TO BREATHE, HEAL & RECONNECT | Trauma-Informed Creative Wellness & Healing Experience designed specifically for parents and children surviving domestic violence & trauma through a supportive, uplifting environment to express, restore, and rebuild together. Presented by ANCHOR'D INC FOUNDATION
Full Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age
*
Gender identity:
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Male
Female
Non-binary
Prefer not to answer
Prefer to answer (below)
Other
Prefer to answer:
Race/ethnicity:
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Black/African American
Hispanic/Latino/a/x
White/Caucasian
Asian/Asian American
Native American/Indigenous
Native Hawaiian/Pacific Islander
Native Hawaiian/Pacific Islander
Middle Eastern/North African
Multiracial
Prefer not to answer
T-Shirt Size
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Please Select
X-Small
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Do you have any allergies or sensitivities?
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Yes
No
Select TWO available volunteer time slots (confirmed time slot will be sent via email)
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9am -12pm EST
12-4pm EST
1-6pm EST
3-7pm EST
Any Time Slot Works For Me
If yes, please specify:
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Food allergies
Fragrance sensitivity
Skin sensitivity
Latex allergy
Not applicable
Other
Do you have any dietary restrictions?
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None
Vegetarian
Vegan
Gluten-free
Not applicable
Are there any materials or activities you should avoid?
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Fragrances
Essential oils
Cosmetic/beauty products
Adhesives
Jewelry materials/metals
Bath/body products
None
Are you a person with a disability or someone who may need an accommodation to fully participate?
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Yes
No
Prefer not to answer
If yes, please tell us about any accommodations that would help participation.
*
How did you hear about this event?
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Our Website
Friend/Family
Community Organization
Instagram
LinkedIn
Facebook
Email
Flyer
Event Partner
Other
Have you volunteered at an Anchor'd Inc./Foundation event before?
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Yes
No
Youth Interaction & Screening
Your volunteer role may involve direct interaction with children or youth under the age of 18.
Are you willing to comply with Anchord Inc. Foundation’s volunteer screening and child-safety requirements, including a background check if required for your assigned role?
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Yes
No
Have you ever been prohibited, restricted, or otherwise determined by a court or governmental authority to be unable to work or volunteer with children or youth?
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Yes
No
Is there anything related to your eligibility to work with children or youth that Anchord Inc. Foundation should be aware of when determining your volunteer assignment?
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Yes
No
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I understand that volunteering with children or youth may require additional screening, training, supervision, or clearance before I am permitted to participate in youth-facing activities. I understand that registration as a volunteer does not guarantee assignment to a youth-facing role.
Photography Release
We may photograph or record participants during the event. Images, video, audio, or other recordings may be used by Anchord Inc. Foundation and its partners for educational, promotional, archival, social media, website, marketing, grant reporting, and other public-facing purposes.
Do you consent to being photographed, filmed, or recorded during the event and for those materials to potentially be shared publicly?
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Yes, I consent.
No, I do not consent.
Privacy Consent
By submitting this form, you acknowledge that the information provided will be used to register you for the event, communicate important event information, plan event activities and resources, and evaluate participation and impact. Your information will be handled in accordance with Anchord Inc. Foundation's privacy practices and will not be publicly displayed without your consent.
Would you like to receive information about future Anchord Inc./Foundation programs, events, and opportunities?
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Yes
No
Would you like to be contacted about future volunteer opportunities?
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Yes
No
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I have read and understand how my information will be used and agree to the collection and use of my information for event registration and planning purposes.
Terms and Conditions
By volunteering for My RELEASE, I acknowledge that participation in the event and its creative, wellness, and interactive activities is voluntary and undertaken at my own discretion. I understand that participation may involve certain materials, activities, or interactions that carry inherent risks, and I agree to disclose any relevant allergies, sensitivities, accessibility needs, or safety concerns. To the fullest extent permitted by law, I agree to indemnify, defend, and hold harmless Anchord Inc. Foundation, its officers, directors, employees, volunteers, partners, and event facilitators from and against any claims, liabilities, damages, losses, or expenses arising from or related to my participation in the event, except to the extent caused by their gross negligence or willful misconduct. I agree to follow all event rules and instructions and confirm that the information provided in this registration is accurate.
Signature
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Submit
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