Project Restore Registration for Adult Leaders

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Thank you for joining us this year! We always welcome strong role models and mentors as this is an extremely important part of Project Restore. We look forward to our week together June 24th to June 28th, 2024 from 9 am-4 pm.

All adult leaders must have been background checked through Lighthouse Ministry. If you have not, you will receive an email with the form which we will process free of charge for you. This is mandatory through Lighthouse for all new volunteers even if your current employment required it of you. Thank you for understanding and helping us be consistent as a youth ministry.

Email *

Full Name *

Address *

Phone number *

Texting available? *

Yes

Emergency contact name and number *

T-shirt size if desired- please sign up before May 24th for ordering (adult unisex sizes)

XXL

3XL

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Please list any food allergies or restrictions OR respond "NA" - we will be having lunch together *

I agree to serve as a leader and youth mentor for the week of June 24th to June 28th arriving at the Garden House on Union Street at 8 am for leader check in. I will arrive at the worksite no later than 8:45 am and stay until all the youth have been picked up no later than 4 pm. Adult leaders will meet at the Garden House directly following the pick up of the last youth from the project site. We will review the next day's activities, complete the daily project eval list, communicate with the project manager, and make sure the tools are returned as applicable and cleaned by the youth team. Please state "Yes", or explain any scheduling differences. We appreciate your serving and know this is a special gift of your valuable time! *

I agree to particpate in a leaders' meeting prior to the week of Project Restore. *

Yes

Required

GENERAL RELEASE - Project Restore Mission and Travel: In consideration of being permitted to participate in Project Restore 2024 as presented by Lighthouse Ministry Inc., New Jersey not-for-profit Corporation, (hereafter “Lighthouse”), I, for myself, personal representatives, heirs, executors, administrators and assigns, do hereby RELEASE, WAIVE, DISCHARGE, and COVENANT NOT TO SUE Lighthouse, First Presbyterian Church, project leaders, officers, staff, youth leaders, directors, and any and all other members of Lighthouse or First Presbyterian Church, and/or other churches participating from all liability to myself, and for all loss or damage on account of injury to my person and property, or resulting in my death, while I am preparing for, traveling to and from, and participating in the Service Week. I, my personal representatives, heirs, executors, administrators and assigns, do hereby agree to indemnify and defend Releasees, from any loss, liability, damage, or cost Releasees may incur due to my preparation for, traveling to and from, and participating in Project Restore.This form will also authorize emergency medical personnel, licensed physicians, or other hospital staff, to carry out emergency medical care deemed necessary for me in an emergency when normal permission is unavailable. I acknowledge that there are certain dangers inherent to Project Restore, such as (but not limited to) traveling in vans and construction activities. I also acknowledge that my own personal physical condition, general athletic ability, and health will be factors in my participation in Project Restore. I acknowledge that I am the best judge of my own abilities and limitations, and I assume the risks of participation in all activities in which I may participate. I represent that my health and physical condition will allow me to fully participate in Project Restore. I acknowledge that I may refuse to perform any activity which I may be requested to perform, and that I may withdraw from Project Restore at any time at my sole discretion. I have been advised that Lighthouse, and its leaders will presume that I am capable of participating in all such activities unless I specifically advise them otherwise.This General Release shall pertain and remain in full force and effect so as I am participating in any part of Project Restore, now and at any future date. I have carefully read the above Release and I know the contents of it, and I type my name in response as my own free act. *

Photo Consent: I give permission to have my image and/or voice photographed or recorded and grant Lighthouse Ministry all rights to use these recordings or photographs in any medium for educational, promotional, advertising, or other purposes that support the mission of the ministry.

Yes

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