Volunteer Info & Consent Form

We ask that all HDA adult volunteers, as well as those under 18 (with the help of a parent or guardian), complete a Volunteer Consent Form, which is due upon arrival.

If you have questions, call us at 606-436-0497 or email janie@hdahome.org

Volunteer Info & Consent Form

"*" indicates required fields

Name of Volunteer*
Address*
When is your church/group scheduled to work with HDA?

Emergency Contact (of a person not on this trip)

Name of Contact*
Address (if different from the address you included above)

Health Information

Are there any Dietary, Medical or any other special needs we need to be aware of?
Insurance Company Address

Agreement

Volunteers participating with the Housing Development Alliance, Inc. (HDA) will be involved in new construction and repair of homes and other construction-related activities. They may also participate in free time activities. Planned evening activities may include visits to places of regional interest. Note: volunteers are not required to engage in any work or recreational activity in which they feel they are not able to participate safely. The foregoing statement of activities has been read and understood. HDA, its agents, employees, and all persons connected therewith are hereby discharged from any and all liability, claims, and cause of action arising out of participating with HDA. Further consent is given to be treated by competent medical personnel as a result of any accident or medical emergency while involved in the activities of HDA. The participant and guardian grant and convey to HDA all rights, title, and interest in any and all photographic images and video or audio recordings made by HDA during participation in activities.
MM slash DD slash YYYY
I certify that I am 18 years of age or older.
This field is for validation purposes and should be left unchanged.
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