Natural Building Workshop & Volunteer Form
Todays date: Expected length or date of stay:
FIRST NAME: LAST NAME:
DATE OF BIRTH:
CITY: STATE: ZIP CODE: HOME PHONE: MOBILE PHONE: #
What you hope to learn:
Skills you have to share:
Waiver: (based on the release form from Habitat for Humanity)
I agree to volunteer my time, labor, services and expertise to this natural building project or class. I understand that I receive no wages in this program. The volunteer program will give me personal satisfaction and the opportunity to expand my experience and understanding level. I understand that the sponsors of this program cannot be liable for any injuries or illness that I or my dependents(s) may suffer. I expressly waive any such claim for compensation or liability on the part of Deanne Bednar, Kensington Park, Raisin River Institute, or any of the other instructors, sponsoring organizations or businesses. I understand that all normal personal, medical and accident insurance coverage is the responsibility of the volunteer.
Print your name:
Sign your name:
DEPENDENTS ~ Name & birthday of dependent(s) less than 18 years of age covered by this waiver:
EMERGENCY CONTACT PEOPLE
NAME: Their work phone: # Their home phone: Their Cell phone: #
NAME: Their work phone: Their home phone: Their Cell phone: #
OTHER INSTRUCTIONS in case of emergency:
Do you have allergies or other relevant medical conditions?
Food Considerations? Need Medication?
Anything else that would be helpful for us to know?
INSURANCE INFORMATION: numbers or copies of cards. (If you have coverage)