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Volunteer Application

Returning volunteers, please click here to sign-up for a shift. 

What's your email address?

Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, The Block Community Outreach will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Street Address
Street Address (line 2)
City
ZIP Code
Are you looking to fulfill court-ordered community service by volunteering with TBCO?
Would you like a Block t-shirt?
What is your shirt size?
What service role(s) are you interested in?







How did you hear about us? (Please select all that apply.) *





If other, please describe. *
Please find TBCO's Volunteer Handbook here: https://theblockoutreach.org/volunteer-roles/
Please type your name to certify that you have received The Block Community Outreach, Inc.’s Volunteer Handbook and that you abide by the policies and procedures outlined in it, as well as all written and verbal instructions of TBCO’s staff members. *

Waiver

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY AND ALL ACTIVITIES ASSOCIATED TBCO, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I am physically fit for this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems, which preclude my participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by TBCO Board of Directors and staff regarding the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my participation in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

A. I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: TBCO and/or their directors, officers, employees, volunteers, representatives, and agents;

B. INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that TBCO and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.

Volunteer Photo & Video Release

I understand while participating in this activity, I may be photographed or filmed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.