Natural Building Workshop & Volunteer Form

Natural Building Workshop & Volunteer Form

FIRST NAME:

LAST NAME

DATE OF BIRTH:

ADDRESS:

CITY:

STATE:

ZIP CODE:

HOME PHONE:

MOBILE PHONE:

I agree to volunteer my time, labor, services and expertise to this natural building project. 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 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:

Today's date:

DEPENDENTS ~ Name & birthday of dependent(s) less than 18 years of age covered by this waiver:

Emergency information:

YOUR NAME:

YOUR BIRTHDAY:

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: (You may include INSURANCE INFORMATION and other relevant MEDICAL INFORMATION / ALLERGIES)

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