The following information is attached and required in order to begin volunteering at Saint John s:

Size: px
Start display at page:

Download "The following information is attached and required in order to begin volunteering at Saint John s:"

Transcription

1 Thank you for your interest in volunteering at Saint John s Program for Real Change. Volunteers are the lifeblood of our organization, giving hundreds of hours each month so we may continue our mission and create better tomorrows for our families. This packet includes all the information you need to get started volunteering here at Saint John s. We look forward to welcoming you to the team! The following information is attached and required in order to begin volunteering at Saint John s: 1. Volunteer Application Form 2. Request for LiveScan Service Please understand that the security of our families is of utmost importance to us. For this reason, all volunteers age 18 years and over must be fingerprinted prior to volunteering here at our shelter. Please note that if you have already been fingerprinted for another organization, you will still need to complete this process prior to volunteering at Saint John s. You can complete your fingerprinting at Capital Live Scan for a nominal fee of $10 (cash) or $12 (check/credit).* Capital Live Scan Broadway - Sacramento, CA Telephone: Hours: Mon-Fri 9:00am to 6:00pm, Sat 10:00am to 2:00pm, closed Sundays *Please bring form #2 (Request for LiveScan Service) to Capital Live Scan. Once you have completed the fingerprinting, please return both forms together. You can scan/ to volunteer@saintjohnsprogram.org, or mail to: Saint John s Program for Real Change Fair Oaks Blvd. #369, Sacramento, CA Attention: Volunteer Coordinator As soon as your clearance forms are received, you can begin volunteering at Saint John s. Shelter tours are held the first and third Saturday of the month at 10. Shelter tours are highly recommended for anyone interested in volunteering at Saint John s. No appointment is needed to participate, and there will be a representative from Capital Live Scan on site to complete your fingerprinting. If you would like to get more information about the tour, volunteer@saintjohnsprogram.org. I hope this information gets you excited about all the wonderful volunteer possibilities here at Saint John s. We truly appreciate your interest and support of our programs. Our programs would not be possible without the work of nearly 500 volunteers each month. We hope you will join us and help the women and children at Saint John s write the next chapter of their lives. If you have any questions or need additional information, please contact us at x 15 or volunteer@saintjohnsprogram.org

2 Volunteer Schedule Daily Volunteer Needs: To schedule a volunteer shift, call or volunteer@saintjohnsprogram.org & include the date, time and shift you would like to volunteer for. SUN. MON. TUES. WED. THURS. FRI. SAT. DONATION CENTER CLOSED KITCHEN Lunch Brunch KITCHEN Dinner CHILDCARE Morning CLOSED Special CHILDCARE Afternoon CLOSED 12PM-3PM 12PM-3PM 12PM-3PM 12PM-3PM Special Special Special Events: MAD ABOUT TEA A Mad Hatter s Tea Party Thursday, May 8 Memorial Auditorium volunteer@saintjohnsprogram.org or call for more information. WINE, WOMEN & SHOES Saturday, October 25 Executive Jet Center MONTHLY CHEF DINNERS 1st Thursday each month Plates Cafe

3 Office Use: Date: Staff: Received: LiveScan Completed: LiveScan Checked: Entered: Confirmation Sent: VOLUNTEER APPLICATION NE: LAST: FIRST: Please check one: New Volunteer OR Continuing Volunteer Since (year) GROUP OR ORGANIZATION: PHONE: DAY: EVE: ADDRESS: CITY, STATE, ZIP: BIRTHDATE: Please indicate which times you are available to volunteer: MORNING: AFTERNOON: EVENING: Please indicate which volunteer programs you are interested in: CHILDCARE KITCHEN DONATION CENTER SPECIAL EVENTS LARGE DONATION PICK UP/DELIVERY (on call) ADMINISTRATION (data entry/filing) OTHER: Special Skills, Interests or Qualifications: Previous Volunteer Experience: EMERGENCY CONTACTS: Name: Phone: Name: Phone: By completing this form, volunteer agrees that he/she has received and accepted the Volunteer Code of Conduct. It is the policy of Saint John s Program for Real Change to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in volunteering with Saint John s Program for Real Change.

4 VOLUNTEER APPLICATION (continued) SAINT JOHN S PROGR FOR REAL CHANGE WAIVER & RELEASE OF LIABILITY Last Name: First Name: Date executed: Day Phone: This release and waiver of Liability releases Saint John s Program for Real Change, a non-profit organization existing under the laws of the State of California and each of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer services for Saint John s Program for Real Change. 1. Volunteer understands that the scope of Volunteer s relationship with Saint John s Program for Real Change is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Saint John s Program for Real Change will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer s services to Saint John s Program for Real Change. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Saint John s Program for Real Change and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Saint John s Program for Real Change. I understand and acknowledge that this Release discharges Saint John s Program for Real Change from any liability or claim that I may have against Saint John s Program for Real Change with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Saint John s Program for Real Change or occurring while I am providing volunteer services. 2. Insurance: Further I understand that Saint John s Program for Real Change does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I expressly waive any such claim or compensation or liability on the part of Saint John s Program for Real Change beyond what may be offered freely by Saint John s Program for Real Change in the event of such injury or medical expenses incurred by me. 3. Medical Treatment: I hereby Release and forever discharge Saint John s Program for Real Change from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with any emergency during my tenure as a volunteer with Saint John s Program for Real Change. 4. Assumption of Risk: I understand that the services I provide to Saint John s Program for Real Change may include activities that may be hazardous to me. As a volunteer, I hereby expressly assume the risk of injury or harm from these activities and Release Saint John s Program for Real Change from all liability for injury, illness, death or property damage resulting from the services I provide as a volunteer or occurring while I am providing volunteer services. 5. Photographic Release: I grant and convey to Saint John s Program for Real Change all right, title and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Saint John s Program for Real Change in connection with my providing volunteer services to Saint John s Program for Real Change. 6. Other: As a volunteer, I expressly agree that this Release in intended to be as broad and inclusive as permitted by the laws of the State of California and that this Release shall be governed by and interpreted in accordance with the laws of the State of California. I agree that in the event that any clause of provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected. I understand that this Release and Waiver of Liability will remain in effect until revoked in writing by me. By signing below, I express my understanding and intend to enter into this Release & Waiver of Liability willingly & voluntarily. Signature Date Parent/Guardian Signature if under 18 Date

5

Please complete the following paperwork and return it to us in one of the following ways:

Please complete the following paperwork and return it to us in one of the following ways: Thank you for your interest in volunteering with us! We are GRATEFUL for every hour that every volunteer serves. Whether your interest is in seeing patients in our HOPE Program, assisting with administrative

More information

The SPCA Eastern Shore offers two main areas of volunteer opportunity. You may choose to participate in more than one area.

The SPCA Eastern Shore offers two main areas of volunteer opportunity. You may choose to participate in more than one area. SPCA Eastern Shore VOLUNTEER APPLICATION VOLUNTEER INFORMATION Name: Street Address: City/State/Zip: Phone: Email Address: Emergency Contact: Age: 18-30 31-40 41-55 55+ How Did You Hear About Our Volunteer

More information

EMERGENCY CONTACT INFORMATION. Name of person to contact in the event of an emergency;

EMERGENCY CONTACT INFORMATION. Name of person to contact in the event of an emergency; BATTLE CREEK AREA HABITAT FOR HUMANITY WOMEN BUILD MAY 5, 9-12, 2018 (Battle Creek) MAY 17-19, 2018 (Marshall) VOLUNTEER APPLICATION (Please return via email, fax or mail) Name: (please print) Maiden Name:

More information

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! HABITAT FOR HUMANITY OF KNOX COUNTY, OHIO, INC. 200 North Main Street Mt. Vernon, OH 43050 Office (740) 393-1434 Fax (749) 393-1157 Release and Waiver of Liability for Minors It is the policy of Habitat

More information

Saturday, April 14, :00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX

Saturday, April 14, :00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX Join us! Saturday, April 14, 2018 10:00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX 77494 www.safetyfestkaty.org Katy Area Safety Fest, in coordination with local Law Enforcement, Emergency

More information

526 Edelweiss Village Parkway Gaylord, MI Office: (989) Fax: (989)

526 Edelweiss Village Parkway Gaylord, MI Office: (989) Fax: (989) Dear Volunteer: Welcome to the Otsego County Habitat for Humanity Family! We hope you will find volunteering with us rewarding as you join us in our mission as a nondenominational Christian housing ministry,

More information

Release and Waiver of Liability. Release and Waiver of Liability for Adults Page 2 & 3. Release and Waiver of Liability for Minor Page 4 & 5

Release and Waiver of Liability. Release and Waiver of Liability for Adults Page 2 & 3. Release and Waiver of Liability for Minor Page 4 & 5 Release and Waiver of Liability Release and Waiver of Liability for Adults Page 2 & 3 Release and Waiver of Liability for Minor Page 4 & 5 1 Release and Waiver of Liability for Adults Adult - An adult

More information

Address City State Zip. Employer (if applicable) Emergency Contact Name: Relationship. If yes, where do you currently attend?

Address City State Zip. Employer (if applicable) Emergency Contact Name: Relationship. If yes, where do you currently attend? Volunteer Application Please complete this application so that we can discover more about you, your interests, your skills, and your intentions in volunteering with us. Please attach a resume with your

More information

Volunteering What is required of a dedicated volunteer? What can you do? Can community service credit be earned by volunteering?

Volunteering What is required of a dedicated volunteer? What can you do? Can community service credit be earned by volunteering? Volunteering Habitat for Humanity is able to achieve its mission of decent affordable homes for low income families because of the many hours donated by dedicated volunteers. New Hampshire Capital Region

More information

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! 109 Harrison St. NE, Leesburg, VA 20176 Phone: 703.737.6772 Fax: 703.737.6788 www.loudounhabitat.org RELEASE AND WAIVER OF LIABILITY FOR MINORS PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS

More information

Page 1 of 5 ALL PAGES MUST BE INCLUDED!

Page 1 of 5 ALL PAGES MUST BE INCLUDED! This Release and Waiver of Liability (the "Release"), executed on this day of, 20 ( / / ), by (the "Volunteer") in favor of Mon County Habitat for Humanity, Inc., a nonprofit corporation ("Habitat"), its

More information

Construction Site Guidelines. Under 18 requires a signed parental permission form (found on

Construction Site Guidelines. Under 18 requires a signed parental permission form (found on Construction Site Guidelines Under 18 requires a signed parental permission form (found on www.hfhcc.org). Please contact Eliza (610-384-7993, ext. 17 or eliza@hfhcc.org) one (1) week before your scheduled

More information

Volunteer Application

Volunteer Application Volunteer Application Circle one: Ms. Mrs. Mr. Dr. Last: First: MI: Street Apt # City: State: Zip: Social Security: DOB Month: Day: Year: Age: Gender: male / female Organization Name: (if volunteering

More information

Townsend ASHBY YOUTH BASEBALL AND SOFTBALL VOLUNTEER APPLICATION PACKAGE

Townsend ASHBY YOUTH BASEBALL AND SOFTBALL VOLUNTEER APPLICATION PACKAGE Townsend ASHBY YOUTH BASEBALL AND SOFTBALL VOLUNTEER APPLICATION PACKAGE VERSION 5.0 UPDATED 02/10/2019 TAYBS Volunteer Application Thank you for your offering your time to volunteer with the Townsend

More information

Hats In The City. February 16-19, 2017 New York Marriott Marquis New York, NY Convention Registration Form. Your Chapter Information.

Hats In The City. February 16-19, 2017 New York Marriott Marquis New York, NY Convention Registration Form. Your Chapter Information. Hats In The City February 16-19, 2017 New York Marriott Marquis New York, NY Convention Registration Form Your Chapter Information Your Chapter Name: Chapter Number: Your Information Supporting Member

More information

Habitat for Humanity

Habitat for Humanity Habitat for Humanity Where: Lenwood Heights, 259 S Acme Rd, 78237 When: Sat., June 23, 2018 You can drive there see instructions attached. It you need a ride we can carpool from St Padre Pio, arrive at

More information

Building Homes, Communities and Hope

Building Homes, Communities and Hope Building Homes, Communities and Hope Thank you choosing Habitat for Humanity ReStores to do your community service hours. The Habitat ReStores sell new and used building materials and the proceeds benefit

More information

Neighborhood Food Distribution Volunteer Packet

Neighborhood Food Distribution Volunteer Packet Neighborhood Food Distribution Volunteer Packet Food Bank Coalition of San Luis Obispo County P.O. Box 2070, Paso Robles, CA 93447 Phone (805) 238-4664 Fax (805) 238-6956 www.slofoodbank.org Ethics Agreement

More information

Dog Shelter Volunteer Application

Dog Shelter Volunteer Application Volunteer Candidate Information Dog Shelter Volunteer Application Name: Home Phone: Cell Phone: Birth Date Address: City: State: Zip: E-mail Address: Availability (Please select the days and time you are

More information

CHARLEY'S ANGELS TEAM FLORIDA VOLUNTEER CHAPLAIN APPLICATION (Must be 18 Years or Older) Full (Legal) Name

CHARLEY'S ANGELS TEAM FLORIDA VOLUNTEER CHAPLAIN APPLICATION (Must be 18 Years or Older) Full (Legal) Name CHARLEY'S ANGELS TEAM FLORIDA VOLUNTEER CHAPLAIN APPLICATION (Must be 18 Years or Older) Full (Legal) City State Zip Code Phone (work) (home) (cell) E-Mail Marital Status: Married Single Divorced Separated

More information

Climb UP So Kids Can Grow UP

Climb UP So Kids Can Grow UP NEPAL EVENT TRIP APPLICATION EVENT TRIP PREFERENCE: Country/Countries of Interest Nepal Trip Dates PERSONAL INFORMATION: First Name Middle Name Last Name Mailing address City State / Province Zip / Postal

More information

Pre Health Professions Conference Saturday, March 4, Registration Form Spots are limited and on a first come first serve basis

Pre Health Professions Conference Saturday, March 4, Registration Form Spots are limited and on a first come first serve basis Office of Diversity and Inclusion Pre Health Professions Conference Saturday, March 4, 2017 Registration Form Spots are limited and on a first come first serve basis Please Note: Registration is not complete

More information

Name: Date: Address: Zip: Phone: Office: What is the best way to reach you?

Name: Date: Address: Zip: Phone: Office:   What is the best way to reach you? HABITAT FOR HUMANITY OF KNOX COUNTY, OHIO, INC. 200 North Main Street Mt. Vernon, OH 43050 Office (740) 393-1434 Fax (749) 393-1157 VOLUNTEER REGISTRATION Many people have indicated an interest in helping

More information

Vendor Programs And Contract

Vendor Programs And Contract THE NICE FESTIVAL NORWALK INTERNATIONAL CULTURAL EXCHANGE Norwalk International Cultural Exchange Vendor Programs And Contract Vendor Categories & Pricing Vendor Types Pricing by January 15, 2017 Pricing

More information

Dog Shelter Volunteer Application

Dog Shelter Volunteer Application Volunteer Candidate Information Dog Shelter Volunteer Application Name: Home Phone: Cell Phone: Birth Date Address: City: State: Zip: E-mail Address: Availability (Please select the days and time you are

More information

Volunteer Orientation Packet Adult

Volunteer Orientation Packet Adult Personal Information Title: (Mr./Mrs./Ms./Dr.) First Name: Last Name: Street Address: City: State: Zip: Home Phone: Work Phone: Cell Phone: Personal E-mail address: If you are affiliated with a group volunteering

More information

COUCH TO 5K RUN. A FOCUS 4 WOMEN CRC FALL 2017 Saturday, November 4, 2017, 9:00 a.m. to 4:00 p.m. Space is limited, so sign up soon!

COUCH TO 5K RUN. A FOCUS 4 WOMEN CRC FALL 2017 Saturday, November 4, 2017, 9:00 a.m. to 4:00 p.m. Space is limited, so sign up soon! COUCH TO 5K RUN A FOCUS 4 WOMEN CRC FALL 2017 Saturday, November 4, 2017, 9:00 a.m. to 4:00 p.m. Space is limited, so sign up soon! Applications will be available starting Tuesday, August 1, 2017, in the

More information

APPLICATION FOR PAID INTERNSHIP

APPLICATION FOR PAID INTERNSHIP APPLICATION FOR PAID INTERNSHIP Habitat for Humanity of San Antonio is an equal opportunity employer. As such, employment decisions for applicants and employees are made without regard to race, color,

More information

Burbank Sister City Committee Burbank Public Library 110 N Glenoaks Blvd. Burbank CA 91502

Burbank Sister City Committee Burbank Public Library 110 N Glenoaks Blvd. Burbank CA 91502 January 7, 2016 Burbank Sister City Committee Burbank Public Library 110 N Glenoaks Blvd. Burbank CA 91502 Dear Bike-a-Thon Rider: We look forward to your participation in the Fourth Annual Bike-a-Thon

More information

Working with the Oglala Lakota Oyate on Pine Ridge Reservation, South Dakota

Working with the Oglala Lakota Oyate on Pine Ridge Reservation, South Dakota Working with the Oglala Lakota Oyate on Pine Ridge Reservation, South Dakota Greetings! I m glad you re coming out to Re-Member. If this is your first time, I look forward to sharing with you the beauty

More information

Office of the City Clerk Sierra Highway, Suite C Palmdale, CA (661) Housing Authority/Volunteer Application

Office of the City Clerk Sierra Highway, Suite C Palmdale, CA (661) Housing Authority/Volunteer Application Office of the City Clerk 38300 Sierra Highway, Suite C Palmdale, CA 93550 (661) 267-5151 Housing Authority/Volunteer Application The City of Palmdale is an equal opportunity employer and does not discriminate

More information

Dog Shelter Volunteer Application

Dog Shelter Volunteer Application Volunteer Candidate Information Dog Shelter Volunteer Application Name: Phone # (h)(c)(w) Address: City: State: Zip: E-mail Address: Availability (Please indicate the days and times you are available from

More information

Stark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver

Stark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver Stark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions Listed on Page 2 Application Due June 22, 2018 Application must be complete in

More information

Registration Form Spots are limited and on a first come first serve basis

Registration Form Spots are limited and on a first come first serve basis Office of Diversity and Inclusion McGovern Medical School s JAMP Symposium April 15 th or April 20 th, 2016 Registration Form Spots are limited and on a first come first serve basis Please Note: Registration

More information

WELCOME to the Atomic City Children s Theater / ACCT II!

WELCOME to the Atomic City Children s Theater / ACCT II! WELCOME to the Atomic City Children s Theater / ACCT II! Required Forms The following forms are required for participation by your student. Please complete and sign all the forms in this packet and return

More information

Tentative Schedule UGA Livestock Judging Camp Athens, Ga :00 am- 12:00pm Registration Double Bridges. 12:00 Orientation Double Bridges

Tentative Schedule UGA Livestock Judging Camp Athens, Ga :00 am- 12:00pm Registration Double Bridges. 12:00 Orientation Double Bridges Tentative Schedule UGA Livestock Judging Camp Athens, Ga 30605 Tuesday, June 26 10:00 am- 12:00pm Registration Double Bridges 12:00 Orientation Double Bridges 1:00pm Note Taking/Reasons Outline Indoor

More information

May 17, 2017 UNR Equestrian Center Reno, NV

May 17, 2017 UNR Equestrian Center Reno, NV May 17, 2017 UNR Equestrian Center Reno, NV The due date for complete applications to be received by the State 4-H Office in Reno is May 5, 2017. Please note that your application requires the signature

More information

Before and After School Care

Before and After School Care Before and After School Care BLAIR FAMILY YMCA 2016-2017 School Year Registration Forms To put Christian principles into practice through programs that build a health spirit, mind and body for all. -YMCA

More information

2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education

2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education 2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education Welcome to NSU Youth Academy! We are excited to have your child with us. In order to provide the best experience for our students

More information

TULANE UNIVERSITY ATHLETICS CAMPS Physical Examination Information. Date / / Name of Camp: Name of Participant: Age: Birth date: / /

TULANE UNIVERSITY ATHLETICS CAMPS Physical Examination Information. Date / / Name of Camp: Name of Participant: Age: Birth date: / / Physical Examination Information Date / / Name of Camp: Name of Participant: Age: Birth date: / / Each participant must EITHER attach a copy of a physician conducted sports examination applicable to this

More information

Camp Registration Form

Camp Registration Form Camp Registration Form Camp is Aug. 4 7. To reserve your child s spot at camp, please fill out this form and submit your deposit to you Children s Pastor. Please fill out one registration form per child.

More information

Create or join a team to bring this initiative to a hospital in your community

Create or join a team to bring this initiative to a hospital in your community Dear Dance Fitness Instructor: Thank you for your participation in the Soaringwords initiative to provide free monthly dance-fitness classes at hospital facilities for the benefit of patients, families,

More information

2019 Beekeeping for Certification Class

2019 Beekeeping for Certification Class 2019 Beekeeping for Certification Class What: Beekeeping for Certification trains and certifies students in practical, successful, and responsible urban beekeeping practices through lectures and hands

More information

God's Way Limited Participant Deed

God's Way Limited Participant Deed Definitions For This Deed God's Way Limited Participant Deed 1. The God s Way Limited (by guarantee) organisation, incorporated in Australia, and currently operating from 98 O'Dea Road, Kingaroy, Queensland,

More information

CITY KIDS DAY CAMP REGISTRATION FORM

CITY KIDS DAY CAMP REGISTRATION FORM RETURN CAMP ENTRY FORM WITH PAYMENT TO: M.C. PARKS 100 E. MICHIGAN BLVD. SUITE 2 MICHIGAN CITY, IN 46360 (219) 873-1506 www.michigancityparks.com CITY KIDS DAY CAMP REGISTRATION FORM 1. HOUSEHOLD INFORMATION

More information

PARTICIPANT AGREEMENT (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

PARTICIPANT AGREEMENT (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT EXHIBIT D PLEASE READ CAREFULLY (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I,, a person being over the age of eighteen, hereby enter this RELEASE

More information

St. Theresa of Avila School Summer Program 2018

St. Theresa of Avila School Summer Program 2018 St. Theresa of Avila School Summer Program 2018 Purpose: St. Theresa of Avila School Summer Program is open to all children entering K0 through the completion of KII. We provide quality care/supervision

More information

Burns Harbor s Presents: The European Market on the Square 2018 Vendor Application

Burns Harbor s Presents: The European Market on the Square 2018 Vendor Application Burns Harbor s Presents: The European Market on the Square 2018 Vendor Application Please read the information below regarding rules of operation and application instructions before signing and remitting

More information

Harleysville and Skippack, Pennsylvania

Harleysville and Skippack, Pennsylvania Volunteer Candidate Information PAWSibilities Animal Rescue Harleysville and Skippack, Pennsylvania Contact Information Name Date of Birth Street Address City ST Zip Code Home Phone Work Cell Phone Email

More information

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 22, 2018 Application

More information

Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church

Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church th Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church Session II: June 12th - June 16th, Performance June 13th; Music On Wheels Academy Music Camp

More information

SUMMER YOUTH PROGRAMS 2018 PARTICIPATION INFORMATION FORM

SUMMER YOUTH PROGRAMS 2018 PARTICIPATION INFORMATION FORM SUMMER YOUTH PROGRAMS 2018 PARTICIPATION INFORMATION FORM Personal Information Child s Name Age of Birth Parent/Legal Guardian 1 Phone Parent/Legal Guardian 2 Phone Address Alternate Phone work cell other

More information

5-STAR ACADEMY OF PERFORMING ARTS Student Registration Packet- WINTER 2019

5-STAR ACADEMY OF PERFORMING ARTS Student Registration Packet- WINTER 2019 5-STAR ACADEMY OF PERFORMING ARTS Student Registration Packet- WINTER 2019 STUDENT NAME: BIRTH DATE: GENDER: _ ADDRESS: PARENT NAME: PARENT EMAIL: PARENT PHONE NUMBER: PARENT WORK NUMBER: SECONDARY CONTACT

More information

Registration Form. Special Information (allergies, medical, behavioral, etc) you would like us to know about the gymnast/dancer:

Registration Form. Special Information (allergies, medical, behavioral, etc) you would like us to know about the gymnast/dancer: Registration Form Gymnast/Dancer Information Name: Date of Birth (MM/DD/YYYY): School (For Scheduling Purposes): School District (For Scheduling Purposes): Special Information (allergies, medical, behavioral,

More information

ATHENS YMCA CAMP KELLEY SUMMER CAMP 2018

ATHENS YMCA CAMP KELLEY SUMMER CAMP 2018 ATHENS YMCA CAMP KELLEY SUMMER CAMP 2018 POLICIES Cost: Full Week (5 Days) $115, Half Week (3 Days) $70; Additional Children: Any additional children will receive a $10 discount on full weeks ONLY. Registration

More information

Cape Cod Community College Summer of Science Program REGISTRATION APPLICATION Page 1 of 6

Cape Cod Community College Summer of Science Program REGISTRATION APPLICATION Page 1 of 6 REGISTRATION APPLICATION Page 1 of 6 INSTRUCTIONS Complete ALL Registration Application Pages (1 6), please make checks payable to:. Mail to: The Center for Corporate and Professional Education, Hyannis

More information

The College of Science, Engineering, and Technology

The College of Science, Engineering, and Technology Health and Science Summer Academy APPLICATION JUNE 25TH JULY 20TH 2018 * MONDAY FRIDAY * 9:00AM 4:00PM I. APPLICANT INFORMATION (PLEASE PRINT CLEARLY OR TYPE) Name [Last] [First] [MI] Birth Date / / Mailing

More information

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 21, 2019 Application

More information

WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS. As consideration for being allowed to participate in the event described below, I agree:

WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS. As consideration for being allowed to participate in the event described below, I agree: WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS As consideration for being allowed to participate in the event described below, I agree: 1. I acknowledge that motor vehicle activity is a potentially

More information

Governors State University, College of Arts and Sciences Summer 2018 STEAM Camp Registration

Governors State University, College of Arts and Sciences Summer 2018 STEAM Camp Registration Governors State University, College of Arts and Sciences Summer 2018 STEAM Camp Registration This is the registration form for the 2018 STEAM Camps at Governors State University. You may register by filling

More information

Math + Leadership Camp Rancho Minerva Middle School July 11-22, Registration Form

Math + Leadership Camp Rancho Minerva Middle School July 11-22, Registration Form Math + Leadership Camp 2016 @ Rancho Minerva Middle School July 11-22, 2016 Registration Form CONTACT INFORMATION Math for America San Diego Email: sandiego@mathforamerica.org Phone: 858-822-6284 OFFICE

More information

Uganda Mission Trip 2017 Information and Application

Uganda Mission Trip 2017 Information and Application Uganda Mission Trip 2017 Information and Application Then I heard the voice of the Lord saying, Whom shall I send? Who will go for us? And I said, Here am I, send me! Isaiah 6:8 Dates June 11 - June 20

More information

Personal Finance Summer Institute for College Readiness Application Instructions:

Personal Finance Summer Institute for College Readiness Application Instructions: Personal Finance Summer Institute for College Readiness Application Instructions: Complete all fields in the Summer Institute Application (pages 2-6), print, and sign. Please print clearly or type. Make

More information

Aftercare Program Enrollment Packet

Aftercare Program Enrollment Packet Aftercare Program 2016-2017 Enrollment Packet 1. Payment Methods Annual Plan Significant savings are available to your family by enrolling in an Annual Plan. Families electing this option for the 2016/17

More information

2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet

2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet 2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet For more information call 617-399-8432 or email Sam at: jrceltics@celtics.com When: Monday, February 19, 2018 & Tuesday, February

More information

*Please bring food donations to check-in the day of the run. Participants will not receive their run t-shirt without this donation.

*Please bring food donations to check-in the day of the run. Participants will not receive their run t-shirt without this donation. WHEN: Friday, June 5, 2015 3:30 PM 6:30 PM WHERE: High School South Athletic Fields WHO: Teams of four from the community. Costumes are encouraged! COST: $10 with food donation* to T.A.S.K.; $15 without

More information

Riley Equine Center, Inc.

Riley Equine Center, Inc. Dear Prospective Volunteer, Thank you for your inquiry about the volunteer opportunities at Riley Equine Center. We are a not-for-profit organization that uses horses to encourage physical and mental development

More information

Luna s House, Inc. Volunteer Agreement

Luna s House, Inc. Volunteer Agreement LHI Volunteer Agreement, R. 5 02/2017 page 1 of 5 Volunteer Agreement P.O. Box 802 Abingdon, MD 21009 (410) 671-2954 Info@lunashouse.org www.lunashouse.org (LHI) is an animal welfare organization currently

More information

SUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM

SUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM SUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM I,, am the parent and/or legal guardian of, a minor child under the age of 18 years. I would like to have my child participate in the following CAMP/PROGRAM at

More information

Registration for Information Technology Summer Camp for rising 7 th, 8 th, and 9 th grade girls

Registration for Information Technology Summer Camp for rising 7 th, 8 th, and 9 th grade girls Registration for Information Technology Summer Camp for rising 7 th, 8 th, and 9 th grade girls Student Name: Date of Birth: If you are a returning camper, indicate what year you attended: School Name:

More information

Stark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver

Stark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver Stark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions and Costs Listed on Page 2 Application Due June 9, 2016 Application must be complete

More information

Cheer Tumbling Registration Form. (Please complete all fields and understand all information stated below) Student Information

Cheer Tumbling Registration Form. (Please complete all fields and understand all information stated below) Student Information Signature of Parent/or Legal Guardian Cheer Tumbling Registration Form (Please complete all fields and understand all information stated below) How did you hear about us? Referral Name: Student Information

More information

UGA Livestock Judging Camp Athens, Georgia June 26-28, Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School:

UGA Livestock Judging Camp Athens, Georgia June 26-28, Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School: PLEASE PRINT UGA Livestock Judging Camp Athens, Georgia June 26-28, 2018 Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School: Email: Grade: Shirt Size: YS YM YL YXL AS AM AL AXL

More information

2017 Vehicle Entry Application Overview

2017 Vehicle Entry Application Overview 2017 Vehicle Entry Application Overview Fees You will be asked for payment only when your vehicle is accepted. Concours o Entry fee for the main field is $125 per car o Includes: Admittance for two people

More information

APPLICATION FOR PART TIME EMPLOYMENT

APPLICATION FOR PART TIME EMPLOYMENT APPLICATION FOR PART TIME EMPLOYMENT Position: Desired Hourly Rate: Last Name First Name Date Address Street City State Zip Code Phone Number Email Address Are you at least 18 years of age or older? Yes

More information

ATLANTIC COUNTY GOVERNMENT Division of Human Resources 1333 Atlantic Avenue, Atlantic City, NJ

ATLANTIC COUNTY GOVERNMENT Division of Human Resources 1333 Atlantic Avenue, Atlantic City, NJ (PLEASE PRINT OR TYPE) ATLANTIC COUNTY GOVERNMENT Division of Human Resources 1333 Atlantic Avenue, Atlantic City, NJ 08401 www.aclink.org VOLUNTEER/INTERN/SPECIAL APPLICATION PERSONAL DATA NAME LAST FIRST

More information

Summer 1197 S. Lumpkin Street, Registration Services Suite 193 Athens, GA Phone: Fax:

Summer 1197 S. Lumpkin Street, Registration Services Suite 193 Athens, GA Phone: Fax: Summer Academy @UGA 1197 S. Lumpkin Street, Registration Services Suite 193 Athens, GA 30602-3603 Phone: 706-542-3537 Fax: 706-542-6596 2015 Request for Financial Assistance Financial assistance is available

More information

Beyond the Hour WHAT IS HOUR OF CODE? GATEWAY SCIENCE MUSEUM & SPONSORS Present... for grades 5-8 TH

Beyond the Hour WHAT IS HOUR OF CODE? GATEWAY SCIENCE MUSEUM & SPONSORS Present... for grades 5-8 TH GATEWAY SCIENCE MUSEUM & 201 7 SPONSORS Present... Beyond the Hour F R I D A Y, AP R IL 14 T H, for grades 5-8 TH 20 17 3:3 0-5PM This workshop is independently paced and picks up at your skill level.

More information

Saturday 9:00 am 11:30 am

Saturday 9:00 am 11:30 am Healthy Body, Healthy Mind Monday Thursday 6:00 pm 8:00 pm Saturday 9:00 am 11:30 am ** s and times are subject to change due to high school & school district events Waiver and Release: WATERVLIET HIGH

More information

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2017 EcoRangers Application, Health Form/Consent, and Liability Waiver

SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2017 EcoRangers Application, Health Form/Consent, and Liability Waiver SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2017 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 23, 2017 Application

More information

Street Address: State: Zip: Phone: Registration Form

Street Address: State: Zip: Phone:   Registration Form 2018 Annual Lampasas Spring Ho Festival Kayak Races Race Day Saturday July 14, 2018 See Division Categories for Start times Early Registration thru July 12th, $10 Registration on Day of Race, $15 Paddler

More information

2018 Beekeeping for Certification Class

2018 Beekeeping for Certification Class The mission of the Milwaukee Center for Urban Beekeeping is to promote honeybees and healthy beekeeping practices in Milwaukee County. We train beekeepers in practical, successful, and responsible urban

More information

ST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS

ST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS ST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS Parent Statement of Understanding The following information is important for the safety and protection of your child. Please read this information and sign

More information

All About Equine Animal Rescue, Inc. El Dorado Hills, CA VOLUNTEER PROGRAMS

All About Equine Animal Rescue, Inc. El Dorado Hills, CA VOLUNTEER PROGRAMS All About Equine Animal Rescue, Inc. El Dorado Hills, CA 95762 VOLUNTEER PROGRAMS What is a volunteer? A volunteer is a person who does some act without being under any obligation to do so and without

More information

Date: Friday Evenings from 5:00pm to 7:00pm Where: Kalanianaole Highway, Waimanalo Phone:

Date: Friday Evenings from 5:00pm to 7:00pm Where: Kalanianaole Highway, Waimanalo   Phone: Date: Friday Evenings from 5:00pm to 7:00pm Where: 41-1029 Kalanianaole Highway, Waimanalo Email: Phone: 808-690-7607 MOMONA NIGHTS VENDOR RULES AND REGULATIONS I. MARKET APPLICATION All vendors must provide

More information

ASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

ASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT ASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT Participant s Name: Age: Date of Birth : (M) (D) (Y) Address: City: Province:

More information

Mission: To inspire, attract and empower girls to explore Science, Technology, Engineering, & Mathematics (STEM) majors and careers.

Mission: To inspire, attract and empower girls to explore Science, Technology, Engineering, & Mathematics (STEM) majors and careers. Mission: To inspire, attract and empower girls to explore Science, Technology, Engineering, & Mathematics (STEM) majors and careers. Sponsored by Space and Naval Warfare Systems Center Atlantic (SSC Atlantic)

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT 985.580.3040 - Houma, LA 512.770.4505 - Austin, TX Email: cnm@comple tenetwork.com NAME (Please Print) POSITION APPLIED FOR DATE APPLICATION FOR EMPLOYMENT Conditions of employment are stated at the end

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION PLEASE COMPLETE ALL PAGES DATE Name Last First Middle Maiden Present address Number Street City State Zip How long Home Telephone ( ) - Social Security No. Mobile Telephone Are you authorized to work in

More information

WILL BE COUNTING ON YOU

WILL BE COUNTING ON YOU Denver Habitat ReStore Volunteer Qualifications Thank you for your interest in volunteering at the Habitat ReStore in Denver. The Habitat ReStores sell new and used building materials and the proceeds

More information

Thank you for your interest in partnering with Food Finders!

Thank you for your interest in partnering with Food Finders! Food Finders is a multiregional non-profit food bank that strives to eliminate hunger and food waste, while improving nutrition in the communities we serve. We are celebrating 29 years of rescuing food

More information

SOFTBALL. pleasanthillrec.com (925)

SOFTBALL. pleasanthillrec.com (925) SOFTBALL pleasanthillrec.com (925) 682-0896 ADULT SOFTBALLL LEAGUE 2018 FALL SEASON The season consists of a seven (7) game schedule, followed by single elimination playoffs. The season begins play on

More information

Pole Vault Camp Oct. 14, 21, 28; Nov. 4, 11 Grades 9-12

Pole Vault Camp Oct. 14, 21, 28; Nov. 4, 11 Grades 9-12 TRACK & FIELD Patrick Georgia October-November Pole Vault Camp Oct. 14, 21, 28; Nov. 4, 11 Grades 9-12 The Spring Season Is Fast Approaching To help you get a jump on the competition, St. Norbert is pleased

More information

APPLICATION FOR ENROLLMENT (One registration form per client)

APPLICATION FOR ENROLLMENT (One registration form per client) 3801 NW 97th Ave, Doral, FL 33178 (305) 921-9076 (786) 331-1000 doral@linguaschool.com www.linguaschool.com/doral First Name Middle Initial Last Name Gender: Male Female Visa Status Day Phone Evening Phone

More information

COUNCIL BLUFFS COMMUNITY SCHOOL DISTRICT VOLUNTARY EARLY RETIREMENT PLAN

COUNCIL BLUFFS COMMUNITY SCHOOL DISTRICT VOLUNTARY EARLY RETIREMENT PLAN 1. PURPOSE COUNCIL BLUFFS COMMUNITY SCHOOL DISTRICT VOLUNTARY EARLY RETIREMENT PLAN It is the expressed intent of the Board, through this plan, to provide an economic incentive to employees to voluntarily

More information

Summer Camp Application INTERNATIONAL DEVELOPMENT 101

Summer Camp Application INTERNATIONAL DEVELOPMENT 101 INTERNATIONAL DEVELOPMENT 101 Student Information Student Name: Sex : Male / Female Student Preferred/Nickname: Mailing Address: Home Phone Number: Cell Phone Number: School: Grade (Entering): Date of

More information

Release of Liability PLEASE DO NOT CHANGE OR ALTER THE WORDING ON THIS WAIVER WITHOUT PRIOR APPROVAL FROM USROWING.

Release of Liability PLEASE DO NOT CHANGE OR ALTER THE WORDING ON THIS WAIVER WITHOUT PRIOR APPROVAL FROM USROWING. Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy

More information

VOLUNTEER APPLICATION and WAIVER

VOLUNTEER APPLICATION and WAIVER VOLUNTEER APPLICATION and WAIVER Please print legibly. When complete, please send to: Volunteer Program, Grand Canyon Trust, 2601 N. Fort Valley Road, Flagstaff, AZ 86001 volunteernow@grandcanyontrust.org

More information

ration Form Registr Paddler 1 Paddler 2 if Tand Race Printed Name: Date of Birth: Phone: Zip: Date Zip: Phone: Single Race Kayak Youth (Ages dem

ration Form Registr Paddler 1 Paddler 2 if Tand Race Printed Name: Date of Birth: Phone: Zip: Date Zip: Phone: Single Race Kayak Youth (Ages dem 2017 Annual Lampasas Spring Ho Festival Kayak Races Race Day Saturday July 8, 2017 See Division Categories for Start times Early Registration thru July 6th, $5 Registration on Day of Race, $10 Printed

More information

Real Estate Investment Talk Radio Featuring Robert Helms

Real Estate Investment Talk Radio Featuring Robert Helms Real Estate Investment Talk Radio Featuring Robert Helms realestateguysradio.com 1-888-489-7723 The Real Estate Guys Annual Investor Summit at Sea Registration Packet Join us for an AMAZING week of education,

More information