Individual Volunteer Registration Form Printable Version Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email Mobile Phone*Have you Participated with Hearts & Hammers before?* Yes No If Yes: number of yearsGroup AffiliationContact Person for Group AffiliationArea of Interest* Warehouse Program Day Home Coordination Inspections/SkilledLabor Marketing/Events Time CommitmentSeason Preference* Spring Summer Fall Other Duration* One-Time Weekly Monthly Annually As Needed Hours Preferred* 1-5 Hrs 6-10 Hrs 11-15 Hrs 16-20 Hrs 20+ Hrs Interests/ExperienceInterests* I am willing and able to work, but have no specific technical skills. I am willing and able to work, and have specific technical skills (see experience) I prefer to scrape and paint. I prefer landscape work. I have Construction/Project Management experience. I prefer not to work on a ladder. I am comfortable working on a step ladder. I am comfortable working on an extension ladder. Experience* Carpentry Exterior Painting Repair/Replace siding and trim Gutter Repair Railing Repair Accessibility Ramp repairs Stair/Walkway Repair Repair/Replace Doors and Wdws Deck and Porch Repair Repair Retaining Walls Technical Inspections Events/ Admin I have a truck or van and would be willing to help transport material to and from worksites I am physically capable and willing to help load and unload materials. I would like to donate materials and/or equipment. I am interested in photography at events. I am interested in administration duties. WAIVER OF LIABILITY 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. 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* I have read and agree to the Terms and Conditions above.