Hands On Baton Rouge

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	be the change. VOLUNTEER!

Welcome to the Hands On Baton Rouge Member Registration.

Use the form below to register as a volunteer for Hands On Baton Rouge projects, courses, and special events.

* denotes a required field

Member Registration Form

First Name *
Last Name *
Date of Birth *
	mm/dd/yyyy
We require date of birth for verification of eligibility with affiliate projects/activities and for demographic reporting for funders.

Mailing Address *
Address Line 1 *
Address Line 2
City *
State *
Zip code *
Parish

Main Phone Number *		Type*
Other Phone Number		Type

Place of Employment

Your login information will be:

Email Type *

E-mail Address *

Re-Enter E-mail Address*

Password *

Re-Enter Password *

Please email me the electronic calendar monthly.

Sign me in Automatically

Click here if you have a disability.

Gender

Race

Education Level

Marital Status

How did you hear about us?

	Internet			TV
	Radio			Word of Mouth
	Friend			Other

Availability

	Weekdays (Monday - Friday)
	Weeknights (Monday - Friday)
	Weekends (Saturday - Sunday)
	Weekdays & Weekends
	Weeknights & Weekends
	All / Anytime
	I am available to work on short notice for important volunteer needs

Terms and Conditions

In connection with my voluntary involvement in activities undertaken for, and with the participation and support of Hands On Baton Rouge, a non-profit charitable organization, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge Hands On Baton Rouge, its officers and directors, employees, agents, and volunteers from all claims, demands, and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from negligence, and I agree to release and hold Hands On Baton Rouge, its officers and directors, employees, agents and volunteers harmless from any cause of action, claim, or suit arising there from.  I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and conditions of this release.
 
I hereby confirm, represent and warrant that I have never been convicted of or charged with a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith.
 
I hereby grant Hands On Baton Rouge the irrevocable right to use forever any film, video tape, audio tape, photographs, slides, or combination thereof, for inclusion in any promotional or advertising purposes, and I agree to appear without pay.

I agree I disagree


	AN AFFILIATE OF