Go Serve Local - Individual Registration

We seek to provide neighborhood transformation as we engage churches and individuals to impact their surrounding community by providing affordable housing remodeling and building new homes.

This form is for registering an individual person. 

All fields below are required to submit this form.

Personal Information

Please enter personal information so we know who you are and how to contact you.



So that we can best serve you, please select your age range.
                   

Organization

Select the organization with which you will participate.

If "other", who? 

Skills

Please select your skills below and specify if you are a professional.
If you have no construction skills, we can still use your help!

Optional
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

Waiver Release

Please read the Waiver Release and check the box if you accept.


Release and Waiver of Liability

This release and waiver of liability (the “Release”) executed on the date stamped below by the registrant, (the “Volunteer”) in favor of Crossroads Mission, Inc., and their partner organizations, and their directors, elders, officers, employees, volunteers, and agents (collectively, “Releasees”). The Volunteer desires to work as a volunteer for Releasees and engage in the activities related to being a volunteer. The Volunteer understands that the activities may include constructing and rehabilitating residential buildings in the California, Portland, Shawnee, Shively and adjacent neighborhoods (the “Project”). The Volunteer does hereby freely, and without duress, execute this Release under the following terms:

1. Waiver and Release.The Volunteer does hereby release and forever discharge and hold harmless Releasees and their successors and assigns from any and all liability, claims, and demands of whatever nature, either in law or in equity, which arise or may hereafter arise from the Volunteer’s work on the Project. The Volunteer understands and acknowledges that this Release discharges the Releasees from any liability or claim that the Volunteer may have against any of them with respect to any bodily injury, personal injury, illness, death, or property damage that may result from Volunteer’s participation in the Project, whether or not any such liability is attributable to the absence of ordinary or even slight care by the Releasees arising out of the Project.

2. Medical Treatment.Except as otherwise agreed to by Crossroads Missions and their partner organizations, their directors, elders, officers, employees, volunteers, and agents, the Volunteer does hereby release and forever discharge all of them from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s work on the Project.

3. Assumption of the Risk.The Volunteer understands that work for on the Project may include activities that may be hazardous to the Volunteer, including, but not limited to, construction, loading and unloading, and transportation to and from the work sites. In connection thereto, the Volunteer recognizes and understands that activities at on the Project may, in some situations, involve inherently dangerous activities. The Volunteer hereby expressly and specifically assumes the risk of injury or harm on the Project and releases the Releasees from all liability for injury, illness, death, or property damage resulting from the activities of the Volunteer’s work on the Project, whether or not any such liability is attributable to the absence of ordinary or even slight care by the Releasees arising out of the Project.

4. Insurance.The Volunteer understands that, except as otherwise agreed to by CrossRoads Missions and their partner organizations, their directors, elders, officers, employees, volunteers, and agents, the Releasees may not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to arrive with medical or health insurance coverage in effect.

5. Photographic Release.The VoIunteer gives the Releasees and any person acting under their authority permission to publish, distribute, broadcast, televise, promote, license, sell and copyright for all purposes, any photograph, videotape, motion picture or sound recording produced directly by any of them or under their sponsorship, which may include my image or likeness and/or my voice. I also authorize the Releasees to reproduce, amplify, simulate, filter or otherwise distort my voice and all instrumental musical and other sound effects produced by me. In addition, I authorize the use of any printed material in connection therewith. I release all claims against the Releasees with respect to copyright ownership, publication and right to privacy. I agree that I shall not receive any fee and that all rights, title, and interest to the above materials and use of them belong to the Releasees. I understand and agree that these materials may be duplicated or distributed with or without charge, and/or altered in any form or manner without future/further compensation or liability, in perpetuity.

6. Other.Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Kentucky, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Kentucky. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court or competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

IN WITNESS WHEREOF, Volunteer has executed this Release as of the day and year first above written.


 I agree   DATE: 03/29/2024     Download
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