2023 TMAD Group Sign-Up Form
TOGETHER WE MAKE A DIFFERENCE


 
Are you a teacher, church youth group, coach, parent or leader of an extracurricular social youth group that would like to get a group of youth involved in taking part in their community? How about a MSU Student involved with a group or organization that would like to participate in TMAD? Great! Complete this online form and we will pair your group with a nonprofit. If you have already paired with a nonprofit please note which nonprofit on the form.    
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Email *
Adult Team Leader Name: *
Main Contact for the Group- First and Last Name
Adult Leader T-Shirt Size *
Main Contact from above question
Leaders Email Address: *
(For Nonprofit Center use only) For event updates
Leader Cell #: *
Must have cell # for Emergency purposes
Group Name: *
Ex. (Add School Name)Student Council, Band, Choir etc.... or make up a name for your group
Has your group arranged to partner with a nonprofit? *
You ARE NOT required to pre-partner but are welcome to do so, otherwise you will be partnered with a nonprofit that has been submitted to the Nonprofit Center.
If you have pre-partnered, what is the nonprofits name:
If you have arranged your own partnership, you must fill out the Project Form as well so we don't pair your group with another project.
SMALLS *
Please calculate your total number of SMALL T-Shirts your group needs, place a "0" if you don't need any of that size
MEDIUMS *
Please calculate your total number of MEDIUM T-Shirts your group needs, place a "0" if you don't need any of that size
LARGES *
Please calculate your total number of LARGE T-Shirts your group needs, place a "0" if you don't need any of that size
X-LARGE *
Please calculate your total number of X-LARGE T-Shirts your group needs, place a "0" if you don't need any of that size
2X-LARGE *
Please calculate your total number of T-Shirts your group needs, place a "0" if you don't need any of that size
3X-LARGE *
Please calculate your total number of 3X-LARGE T-Shirts your group needs, place a "0" if you don't need any of that size
4X-LARGE *
Please calculate your total number of 4X-LARGE T-Shirts your group needs, place a "0" if you don't need any of that size
Total # of Teens: *
Please calculate your total number of youth participating
Total # of Adults: *
Please calculate your total number of Adults
Group Member Sign Up List *
Please enter youth names with their ages, ex. Joe Smith-14.  (additional group leaders put ADULT next to their name)
Comments/Other:
Photo/Liability Release
Your attendance and/or participation in the program and event, “Together We Make a Difference”, grants the Office of Marketing and Public Information at Midwestern State University (MSU Texas) permission to use photographs/video taken for promoting the University and University programs. Photographs/video may be used in a variety of advertising outlets including, but not limited to, print and television ads, Internet, brochures, or posters. Attendance and/or participation by any minor or person under guardianship is deemed sanctioned by parent/guardian of said participant or attendee and implicitly grants above mentioned release to Midwestern State University (MSU Texas) as well as indemnifies Midwestern State University (MSU Texas) its board, staff, agents and volunteers against any and all recourse resulting from said attendance or participating activity.

Furthermore, your attendance and/or participation also releases, discharges and hold harmless the sponsoring and organizing parties and their officers, agents, employees, staff and volunteers from all liability, claims, or actions for which I may have or claim to have against any of them for personal injury or damages as a result of participation in this event.
A copy of your responses will be emailed to the address you provided.
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