Group Volunteer Application at Heartspring

Group/Corporate Information

*Group/Corporate Name:

*Address:

*City:

*State:

*Zip Code:

*Contact Person:

*Contact Phone:

( ) -

*Contact Email:

Approx. number in your volunteer group:

Areas of Volunteer Interest (please check all that apply)

Host special activities (music, sports, arts and crafts, BBQs, etc)
Yard work/gardening/landscaping
Cleaning projects (homes, classrooms, vehicles)
Provide volunteers at special events:
	Spring - CARE Walk
	Winter - Lights on the Lake
	Fall - Pedal Fest
Other volunteer interest:

Yes No

*I do hereby for above group, and all who may hereafter claim through or for me/us, waive and release Heartspring from all claims, rights and causes of action accruing in my/our favor as a result of personal injury, loss of life, or loss of property against Heartspring and their representatives while volunteering at/for Heartspring. I understand normal risk associated with the activity described above, and I agree to allow the above-described group for whom I am responsible, to participate in that activity. I further agree with them that no suit or action at law shall be instituted for the above reasons by others or me in my behalf.

Yes No

*I hereby agree that any information obtained about agencies or clients while volunteering is confidential.

Yes No

*I hereby agree and consent to allow Heartspring to photograph or videotape the above-named group for advertising and publicity purposes by Heartspring, and I waive all claims for any compensation for such use or for damages.