Service Raleigh

First name*

Last name*

Date of birth*

MM/DD/YYYY

Email*

Confirm email*

Phone number*

Shirt size*

Emergency contact*

Contact phone number*

Relation to contact*

*All Service Raleigh activities will follow current COVID-19 guidelines and the guidelines set by the volunteer site.

Other info (allergies, physical disabilities, etc.)

(Check if you want to submit the above optional request)

Worksite Requests

There is a list of Partners on our website. Please indicate the ONE Partner you would like to be assigned to. If there are Partners not listed on our website, you may still indicate those. Please note that this does not guarantee you will be assigned to any of those Partners.

(Check if you want to submit the above optional request)

Please indicate ONE volunteer group that you would like to lead (i.e. student organization, team, etc.) AND the approximate size of that volunteer group. Please note that this does not guarantee you will be assigned to that volunteer group.

(Check if you want to submit the above optional request)

Site Leader Questionnaire

Why do you think service is important?*

Why do you want to be a site leader?*

Have you been a site leader before? If so*

when and what did you learn from that experience?*

Are there any types of service or specific causes that interest you the most? List your top 3.*

Do you have any previous experience in facilitating reflection and meaningful dialogue in a group setting?*

Do you prefer to be assigned to a particular partner site*

or prefer to have a certain volunteer group included in the volunteers you will lead? Indicate here if so.*

Site leaders will be required to complete the online training date by the following date. Please email siteleaders@serviceraleigh.org if you have any questions.*

If I am not selected as a site leader, I understand that I will be registered as a volunteer. If I do not wish to be a volunteer, then I must cancel my registration.*

I understand that serving as a site leader is an important responsibility and integral to the success of Service Raleigh. Should I be selected, I agree to complete my responsibilities in a timely manner and communicate any concerns that I may have with the Service Raleigh Co-Chairs.*

Site Leaders are required to complete an online training before Service Raleigh. This will be a short online training that will outline your responsibilities as a Site Leader. If you have any questions or concerns about the position please email siteleaders@serviceraleigh.org.

I understand that I must complete the online Site Leader Training before March 31st at 11:59 pm.*

You must read and agree to the following waiver in order to participate in this event.

You must read and agree to the following waiver in order to participate in this event.

I know and understand that some Service Raleigh activities require strenuous physical exertion. I attest that I am medically able to perform these activities and agree to do so. I assume all risks associated with participating in this event, including to but not limited to: falls, contact with other participants, effects of the weather, traffic, use of software for online events, and the condition of the site. All such and related risks being known and appreciated by me.

Having read and understood this waiver and in consideration of your accepting my registration, I for myself and anyone entitled to act on my behalf, waive and release Service Raleigh, North Carolina State University, all partner organizations, volunteers, their officers, employees, agents, representatives and successors from all claims or liabilities of any kind resulting from my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

I grant permission to all foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes. I hereby waive any right to inspect or approve the finished electronic, photographic, or printed matter that may be used in conjunction with them now or in the future. I will abide by these guidelines.

I have read and agree to the above waiver*

(For participants under the age of 18) I certify that I am the parent/guardian of the participant listed above, and I have read and agree to the above waiver on behalf of my child.

I have read and agree to the above waiver*