Adult Waiver Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency Contact PersonName(Required) First Last Emergency Contact Phone(Required)Volunteer Team(Required)NoneH&H Friends and Family3MACE HandymanACI Asphalt & ConcreteAdolfson & Peterson ConstructionAdvent UMCAdvent Lutheran AnokaAECOMAllianzAmerican National BankAmerican Subcontractors AssociationAndres ConstructionASHRAEAssociated BRC/ Associated BankASCEASPEAuto-Owners InsuranceAzroBaker AssociatesBauhaus Brew LabsBeck GroupBell BankBerg DrywallBKV GroupBig-D ConstructionBLUveraBurns & McDonnellBWBRCarpenter Evert & AssociatesCE ContractingCatholic Heart Work CampC. G. Hill and SonsCHSCity of DallasCity of MinneapolisColliers InternationalCommunity of Minnetonka BeachCreative HomesCuningham GroupDallas City Attorney’s OfficeDark Clouds Silver LiningDavis & AssociatesDavis Healthcare Real-estateDent Mechanic GroupDo Good RosevilleDJ KranzDunhamDunwoodyECMCEhlersEgan CompanyESGFaithful & GouldFairmont HotelFederal Reserve BankFinal Coat PaintingFirst Presbyterian of OmahaFive Oaks ChurchFrana CompaniesGeneral MillsGenslerGerdauGood Sam UMCGracoGary Plant MootyGraybarGreiner ConstructionHarris MechanicalHBG DesignHennepin CountyHGA ArchitectsHKSHolderHoly Cross ELCA KansasHome DepotHorwitz MechanicalHousing FirstHumanaHunt ElectricHyperthermInvescoIREMIOCCJHP ArchitectureJe DunnJLG ArchitectsKeurig Dr. PepperInnovative Building & DesignImmanuel Lutheran ChurchLifetime constructionL'Oreal ParisKeller WilliamsKnutson ConstructionKraus-Anderson ConstructionLead222Leadous GroupLifetouchLord of Life ChurchMargolisMarvinMcGough ConstructionMERGEMetropolitan EndodonticsMeyer Borgam JohnsonMGICMN Builders ExchangeMMCMNCARMNSEAMinnesota Construction Law ServiceMorning CalmMortensonMSCANCELNDSU Twin Cities AlumniNexploreNorhartNotre Dame Alumni ClubO'Keefe WoodOld National BankOlympia TechOpusOptumParsons ElectricPagePerkins + WillPhillips and TemroPope ArchitectsPremier BanksProsperaQuartersawnRachel Contracting, Inc.Reell ManufacturingRestaurant TechnologiesRiver Valley DisciplesRJM ConstructionRotary Club of EdinaRouzerRSP ArchitectsSicoraSiteKickSkiles GroupSpaw GlassSpirit of HopeStahlSt. Peders ChurchSt. Pius XSt. Monica's ChurchSt. Stephen Presbyterian ChurchSt. ThereseSt. Thomas Becket ChurchStructure ToneSambatekSchadegg MechanicalSharper ManagementSherwin WilliamsSLCStillwater Sunrise RotaryStinson Leonard StreetSurly Gives a DamnSummit MortgageSynchrony FinancialTarget CorpTCF BankTee It Up For The TroopsTexas Air SystemsThe Hammer HouseThrivent FinancialThomson ReutersTimcoUnitedHealth CareViking ElectricVince KingWalkerWedgewoodWestminister Presbyterian ChurchWestwood Lutheran ChurchWeek of HopeWhole FoodsWhiting-Turner ContractorsWorld Architects and EngineersXcel EnergySelect your Team or choose None.In consideration of the opportunity afforded me to volunteer my labor, materials, and/or equipment to the Hearts & Hammers - Twin Cities, Inc. (H&H) Project, a project in which the homes of low-income disabled and elderly persons will be repaired by volunteers, and in light of the aims and purposes of the community service provided by H&H, in organizing this project, I hereby waive any right, demands, injuries, damages, claims, actions, or cause of action arising as a result of my participation in the Project from which any liability may or could accrue against H&H, its officers and directors and employees, or against any other person or entity volunteering labor, materials, and/or equipment to the Project, collectively or individually. Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damage to my property due to any active or passive negligence, or other conduct in connection with my activities for the Project, including but not limited to claims arising out of lead-based paint or other hazardous materials, but this waiver shall not apply to conduct that is fraudulent, intentional, or grossly negligent. This waiver also extends to any illnesses I could contract as a result of my participation, such as COVID-19, or other airborne or surface-borne illnesses. I agree that this release is binding upon my heirs, executors, administrators and assigns. I also recognize that the activities associated with this Project are potentially dangerous and could result in serious personal injury or property damage. Nevertheless, I assume the risk of such injury, whether these risks are known or unknown to me, and I absolve H&H and all affiliated individuals and companies from all responsibility or liability of any description. I also grant H&H unrestricted permission to use, copy, reproduce, alter, display, distribute, publish, and/or exhibit any pictures, video or narrative in which I may be included through any means of communication whatsoever for any lawful purpose whatsoever. I further release and discharge H&H from any and all claims arising out of such use or activity. I am eighteen 18 years of age or older, and I have read the Safety Guidelines.Adult Agreement(Required) I have read and agree to the Terms and Conditions above. Hearts & Hammers - Twin Cities 2603 Fairview Avenue North St Paul MN 55113 651-636-0797 www.heartsandhammers.orgUntitledFirst ChoiceSecond ChoiceThird ChoicePhoneThis field is for validation purposes and should be left unchanged.