Yes!!! I’ll be a good neighbor and support my community this summer as a
Winnsboro Community Service Days Volunteer
Return this form to your church as soon as possible (if your church is a supporting church; discuss with your pastor) or to First United Methodist Church by noon, June 16. Your church, service club, employer, or group may be organizing a work project that will be part of this program; otherwise, you will be contacted by our Team for your specific assignment prior to the Service Days Event on June 27th. If you are a community service volunteer, please return this form to: Winnsboro Community Service Days c/o Allen Snider 301 Church St. Winnsboro, TX 75494 Name: __________________________________________ Phone numbers where you may be reached: Work:________________________________ Home:____________________________ Cell:_________________________________ Address:_________________________________________________________________________________ Street City State Zip Check your volunteer status: Community Volunteer First Presbyterian Church Central Christian Church First Baptist Church Pine St. Baptist Church Walnut St. Baptist Presbyterian Hospital Winnsboro I.S.D. City Government First Methodist Church Johnston Unit Chamber of Commerce Keller’s Creamery His House Ministries Hynson Chapel CM.E. Lions Club Pilot Club Tinney Chapel Methodist Rotary Club Civic Club 4-H Girl Scouts Boy Scouts Other (please write in below)
Please check the mission project types in which you would like to participate. Please feel free to check all that apply or write in possibilities: Home Yard Improvement Nursing Home Feed the Hungry City Beautification Skilled carpenter Licensed Plumber Licensed Volunteer breakfast
Time(s) you will be able to work on Saturday, June 27: Morning (8/9:00 am- noon) Evening (3/4:00-6:00 pm or done) Afternoon (1/2:00-3/4:00 pm)
The scheduling team will contact you as indicated above. Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God. Hebrews 13:16 NRSV He has told you, O mortal, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly with your God? Micah 6:8 NRSV
Date: ________________________________ VOLUNTEER RELEASE AGREEMENT Minor Volunteer My child (currently age ______ years) intends to participate in activities related to Winnsboro Community Service Days (WCSD). I understand that Winnsboro Community Service Days (WCSD) will include activities, such as yard work, repair work, clean-up work and other activities, which might result in the possibility of accident or injury. My child’s participation in Winnsboro Community Service Days (WCSD) is voluntary and I hereby give permission for my child to participate in Winnsboro Community Service Days (WCSD) and agree, on my behalf and on behalf of my child, to accept and assume all risks, which may arise during or as a result of such participation. In consideration for my child being given the opportunity to participate in Winnsboro Community Service Days (WCSD), I (on my behalf, on behalf of my child and on behalf of our respective estate, heirs, successors and any other party claiming by or through us) hereby release and agree to indemnify and hold harmless the churches, businesses, service clubs, institutions and agencies of Winnsboro Texas, their respective officers, agents, employees, members and all other participants in Winnsboro Community Service Days (WCSD) from and against any and all claims, losses, injury, damages, causes of actions, suits, and liability of any kind, including, without limitation, expenses of litigation, court costs, and attorneys’ fees, which arise out of or are in any way connected with my child’s participation in Winnsboro Community Service Days (WCSD), including, without limitation, injury to or death of my child or any other person or damage to any real or personal property of my child's, of mine or others. Such release and indemnity shall apply in any circumstance, including, without limitation, where the claims, losses, damages, causes of action, suits, or liability arise, in whole or in part, from the negligence of my child, me or such churches, officers, agents, employees, members, volunteers, participants or otherwise. I understand that, in the event medical treatment is required, every reasonable effort will be made to contact me. However, if I cannot be reasonably reached, I hereby give my permission to Winnsboro Community Service Days (WCSD), or an adult participant in Winnsboro Community Service Days (WCSD), at my sole cost and expense, to consent to and secure medical, dental, surgical and hospital care, under the general or special supervision and on the advice of any licensed physician or dentist, as reasonably necessary for my child’s well being. I agree to indemnify and hold WCSC harmless from all such healthcare costs incurred for my child. I understand that this Volunteer Release Agreement affects my and/or my child’s legal rights and that my execution of this Volunteer Release Agreement is a condition precedent to my child’s participation in Winnsboro Community Service Days (WCSD). _____________________________________ Name of Minor Volunteer Contact information (please print): ____________________________________ Signature of Parent or Legal Guardian
Parent/Guardian:_________________________________________________________________________ name Home/Work/Cell Phone #s:_______________________________________________________________________ Home Work Cell Other Emergency Contact:________________________________________________________________________ WCSD at First United Methodist Church 301 Church St., Winnsboro, Texas Office: 903-342-6172Fax: 903-342-3177