Group Volunteer Application

- Group Information -
Group Name:*	Group Age Range:*	Group Size:*

Address:*	City:*	Zip:*

E-mail:*	Phone:*	Fax:*

- Primary Contact -
Name:*	E-Mail:*	Phone:*

- Secondary Contact -
Name:*	E-Mail:*	Phone:*

For every five (5) volunteers who are minors (under the age of 18) at The Servant Garden,
at least one (1) chaperone over the age of 18 must be present during the entire period of volunteering.
Please describe the ages of the members in your group and how many chaperones will be present
(i.e., ten 12-year-olds, five 17-year-olds, and three adult chaperones).*

- Select all the Times/Days your group is interested in volunteering -*

Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
6-7AM	6-7AM	6-7AM	6-7AM	6-7AM	6-7AM
7-8AM	7-8AM	7-8AM	7-8AM	7-8AM	7-8AM
8-9AM	8-9AM	8-9AM	8-9AM	8-9AM	8-9AM
9-10AM	9-10AM	9-10AM	9-10AM	9-10AM	9-10AM
10-11AM	10-11AM	10-11AM	10-11AM	10-11AM	10-11AM
11A-12P	11A-12P	11A-12P	11A-12P	11A-12P	11A-12P
12-1PM	12-1PM	12-1PM	12-1PM	12-1PM	12-1PM
1-2PM	1-2PM	1-2PM	1-2PM	1-2PM	1-2PM
2-3PM	2-3PM	2-3PM	2-3PM	2-3PM	2-3PM

Will your group be able to volunteer regularly at The Servant Garden?*
How did you hear about The Servant Garden?*
Would your group, or members of your group, be willing to deliver produce to locations specified by The Servant Garden?*
Does any member of your group have any health conditions (allergies, back problems, etc.) that would prevent them from performing demanding physical labor outdoors? If yes, explain.*

Does any member of your group have any experience garding, cultivating or farming? If yes, explain.*

Why does your group want to volunteer for The Servant Garden?*

Would you like to receive our news letter?*

Security Check:*

I certify that I have answered everything on this application truthfully and to the best of my knowledge and have not given any information intended to deceive or commit fraud or made any false statement that might be construed as such.
The group/organization shall indemnify, defend and hold The Servant Garden for any loss, bodily injury, or damage incurred by the group and/or organization members, and/or the result of the group's/organization's actions or conduct.
The group/organization members agree not to consume, use, possess, or be under the influence of any drug or alcohol products while volunteering for The Servant Garden.
The group/organization appointed supervisors shall be responsible at all times for the actions, character, control, supervision and conduct of the group members.
The group/organization understands that any conduct or pattern of conduct that would tend to disrupt, diminish, or otherwise jeopardize public trust in The Servant Garden will result in dismissal.
I acknowledge that volunteer photographs may be taken for possible use in: news releases, internal publications, promotional and educational materials.
The group/organization authorizes The Servant Garden to investigate all statements contained in this application for the purpose of being considered for a volunteer position.
The group/organization acknowledges that its members are offering their servicesstrictly on a volunteer basis and no offer of paid employment is implied. Furthermore, the group/organization or The Servant Garden can terminate the volunteer relationship at any time without prior notice.
A responsible adult group/organization appointed supervisor must accompany volunteers under the age of 18 at all times during the stated period of volunteering work, after the aforesaid individual has presented the Group Contact with a signed Parental Consent Form, which must remain on file with the Group Coordinator prior to and during the under-aged individuals period of volunteering service.

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