Volunteer Registration

Volunteer Registration

Return form to

Name/Team Leader /Individual: ______

Address: ______

Phone: ______Cell:______

Email: ______

Second Contact Person Name (if applies) ______Phone______

Church: ______Conference______

Organization: ______

Date /s Team/Individual can volunteer: ______

Team Size: ______Adults______Gender Breakdown: Male_____ Female______

Youth______(Youth have to be 18 years of age to do muck outs because of insurance and liability)

ERT Training ___yes ___no Current Badge ___yes ___no Safe Sanctuaries Training? ___yes ___no

Do you need housing? ____ yes ____no Do you have air mattresses or similar alternative ? ___yes ___ no

Are you willing to travel to projects that may not be near your housing site? ____Yes ____ No

Type of Team- Clean up, rebuild, other______

Can you bring tools? ______Yes ______No What kind? ______

We will try to provide proper equipment to do the job i.e. masks, gloves, boots. There will likely be mold, mud both dried and wet, and debris. Please be sure volunteers have long pants or jeans, sturdy or steel-toed shoes, VIM Insurance is suggested when timing allows. Otherwise, make sure participants carry insurance card

Skills of Team: ______

______

______

______

Everyone on team needs to have an updated Tetanus shot. UMVIM insurance is suggested when timing allows. Reminder that Medical Release, Liability, and Medical Information forms should be completed by each volunteer.

Return form to If you have any other questions you may contact Rev. Stephanie Gottschalk, WPAUMC Missions Coordinator, at or 412-926-0498. Once we confirm dates and number, our team will be work on trying to place your team or Individual with an appropriate site.