Flint Hills Volunteer Center Neighbor 2 Neighbor Group Volunteer Application

Group Volunteer Information
This enrollment is only if you are interested in helping with the Neighbor 2 Neighbor program.
Group/Organization*
Point of Contact:*
First Last
Address*
Please list local addresses only.

Street Address ZIP Code
Email*
Phone*
Number of members interested in volunteering:*

Liability Waiver
All volunteers must read the liability waiver provided below and agree to its terms prior to participation.
By checking this box, I am acknowledging that I have read and agree to all the terms of the Neighbor 2 Neighbor Program liability waiver.*
I agree.

I, the undersigned, being a volunteer in the Neighbor 2 Neighbor Program (hereinafter "the Program"), or being the parent or legal guardian of such a volunteer in the Program, in consideration for my or another's participation in the Program hereby, for myself and any volunteer for whom I am a parent or legal guardian, release, discharge, and hold harmless the Flint Hills Volunteer Center, and their employees from any and all actions, causes of action, claims or any liabilities whatsoever, known or unknown, now existing or which may arise in the future on account of or in any way related to or arising our of my participation in the Program.

I further state that I am aware of and understand the inherent risks, hazards and dangers associated with the projects I am volunteering for, including threats to life and limb (slipping and falling on snow or ice), being exposed to harsh weather conditions (cold temperatures, extreme heat, and precipitation), and perhaps experiencing complications associated with the weather conditions and physical exertion (fainting, collapse, exhaustion, or other more serious complications). I understand that these are examples of the risks, hazards, and dangers associated with the Neighbors Helping Neighbors Program but not necessarily a complete list.

I further state that my physical health (if I am the volunteer) or the physical health of any volunteer for whom I am a parent or legal guardian, is now and will be during the volunteer's participation in the Program, sufficiently sound to permit such person(s) to safely participate in this Program.
Media Release & Promotional Materials
We give permission for the Flint Hills Volunteer Center to publish the photographs taken of us and our name for use in printed publications and websites. We acknowledge that since our participation in publications and websites is voluntary, we will not receive financial compensation. We further agree that our participation in any publication and website produced confers upon us no rights of ownership whatsoever. We release FHVC, it's contractors, and it's employees from liability for any claims by us or a third party in connection with our participation.*
- WE DO authorize the use of my name and picture for this purpose.
- WE DO NOT authorize the use of my name and picture for this purpose.

Step 1 of 5

Group Volunteer Information

Accessibility

Liability Waiver

Media Release & Promotional Materials

Acknowledgement of Enrollment

Volunteer Signature