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Maytown Center Volunteer Application


Name______________________________ Adult__ Youth__ M/F____
Phone # (_____) ____________________   (______) ____________________________

Address________________________________________________________________

_____________________________ e-mail____________________________________

In Case of an Emergency contact ________________ at _________________
         Name  Phone #
Insurance # ______________________________Company_________________

List any allergies/medical conditions: ___________________________________________________________________________
________________________________________________________________


Please read the following and sign:
1. No Tobacco products in buildings.
2. No Alcohol/drug products on property.
3. Clean up after using facility.
4. The Center assumes no responsibility for lost, stolen or misplaced items.
5. The Center assumes no responsibility for accident or injury while using buildings or on property.

I have read & agree to the above expectations:

Sign:___________________________________________ Date:_____________

What are your gifts and interests?  Your talent may be able to be used during your time volunteering at Maytown. Please check the areas that apply to your interests.

? Carpentry
? Plumbing
? Electrical Work
? Yard Work
? Organization
? Computers
? Teaching/Education
? Accounting
? Literacy/GED
? Working with Children/teens
? Cooking
? Cleaning
? Music
? Art
? Drama
? Sewing
? Physical Fitness
? Grant Writing
? Bike repair
? Other__________