Volunteer at ReStore – Central Delaware Habitat for Humanity

Volunteer Contact
Date*
MM slash DD slash YYYY
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Home phone*
Cell phone*
Email*
Date of birth*
MM slash DD slash YYYY
Employer
Occupation
Group name
This box to be filled out only by individuals who are registering as a member of a group, such as a company, religious, or civic organization.
Place of worship
Other community groups you participate in:
How did you hear about us?
Availability*
You may select any time you are available.
- Tuesday Morning
- Tuesday Afternoon
- Wednesday Morning
- Wednesday Afternoon
- Thursday Morning
- Thursday Afternoon
- Friday Morning
- Friday Afternoon
- Saturday Morning
- Saturday Afternoon
Skills and services
Central Delaware Habitat for Humanity ReStore is in need of a wide range of services and areas of expertise. If you have a skill level in any of the following that you would like to provide, please indicate below:
- Cleaning
- Organization
- Pick-Up Driver
- Lawn Care
- Painting
- Hauling
- Heavy Lifting
- Computer Savvy
- Special Event Planning
- Cash Register
- Restoration/Repairs
- Retail Experience
- Phone Etiquette
- Filing
- Construction
- Electronics
- Dusting
- Other
Other
Medical Information
Emergency contact name
First Last
Emergency contact address
Street Address Address Line 2 City State ZIP Code
Emergency contact home phone
Emergency contact cell phone
Emergency contact relationship to you
Please list all medical conditions and/or of which we should be aware:
Please list all allergies:
Can you lift 50 pounds or more if needed?
- Yes
- No
Service Information
Have you done community service before?
- Yes
- No
If yes, please explain.
Have you done community service at our Habitat ReStore before?
- Yes
- No
Are you here to do community service hours?
- Yes
- No
If yes, how many hours do you need to complete?
What do you need to complete community service hours for?
- School
- Church
- Other
Other
Have you ever been convicted of a felony?
- Yes
- No
If yes, please explain:
Are you here to do community service by court order?
- Yes
- No
If yes, please explain:
Are you currently on probation?
- Yes
- No
Probation officer's name
First Last
County
Probation officer's phone
Probation officer's email
Are you currently enrolled in a special program or organization that requires you to volunteer or do community service?
- Yes
- No
If you answered yes, please list program or organization:
Release and Waiver of Liability
THIS RELEASE AND WAIVER OF LIABILITY (the “Release”) is made by the Volunteer named on page 1 (the “Volunteer”) in favor of CENTRAL DELAWARE HABITAT FOR HUMANITY (CDHFH or Habitat), a Delaware non-profit corporation and its directors, officers, employees, and agents.
The volunteer named below desires to volunteer at the CDHFH RESTORE and the activities related to the project.
The volunteer does hereby freely, voluntarily, and without duress execute this release under the following terms:
1. WAIVER AND RELEASE: The volunteer does hereby release and forever discharge and hold harmless CDHFH and their successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or equity, which arise or may hereafter arise from the volunteer’s participation in Habitat’s project(s). The volunteer understands that this release discharges Habitat from any liability or claim that the volunteer may have against CDHFH with respect to any bodily injury, personal injury, illness, death, or property damage that may result from the volunteer’s participation in Habitat’s project(s). The volunteer also understands that CDHFH does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance.
2. MEDICAL TREATMENT: The volunteer does hereby release and forever discharge CDHFH from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the volunteer’s participation in CDHFH project(s). The volunteer understands that s/he is responsible for securing appropriate medical insurance coverage.
3. ASSUMPTION OF RISK: The volunteer understands that the CDHFH building project may include activities that may be hazardous to the volunteer and that the food and accommodations may be donated by CDHFH and beyond the control of CDHFH. The volunteer hereby expressly and specifically assumes the risk or harm in their activities and releases CDHFH from all liability from injury, illness, death or property damage and/or theft resulting from the activities of the volunteer’s participation in CDHFH project(s). CDHFH retains the right to limit or prohibit participation of the volunteer in the activities of the project(s) if CDHFH determines that such participation will not be in the best interests of CDHFH or the volunteer. The volunteer understands that s/he will be responsible for the payment of any expenses incurred as a result of application of this section.
4. PHOTOGRAPHIC RELEASES: The volunteer does hereby grant and convey unto CDHFH all right, title, and interest in any and all photographic images and video or audio recordings made by CDHFH during Habitat’s project(s).
5. OTHER: The volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Delaware, and that this release shall be governed by and be interpreted in accordance with the laws of the State of Delaware. The volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such a clause or provision shall not otherwise affect the remaining provision of this Release which shall continue to be enforceable.
6. BACKGROUND CHECK: CDHFH may conduct a background and sexual harassment check at its discretion.
7. THEFT: Any theft charge will make the applicant ineligible for volunteer participation.
IN WITNESS WHEREOF, the volunteer has executed this Release as of the day and year first above written.
Name*
First Last
Signature*
Date*
MM slash DD slash YYYY
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
If the volunteer is below the age of 18, the signature of the Parent or Legal Guardian is required:
Parent/guardian name
First Last
Parent/guardian signature
Parent/guardian relationship
Parent/guardian phone
CAPTCHA

Volunteer Contact

Medical Information

Service Information

Release and Waiver of Liability

IN WITNESS WHEREOF, the volunteer has executed this Release as of the day and year first above written.