(Adult) Service Liability/Media Release Form
Stitching Hearts Worldwide is a 501(c)(3) non-profit, tax exempt, government recognized entity. Our mission is to provide service opportunities for individuals, groups, and businesses wanting to help those in need. We offer caring volunteers the necessary tools and materials to make handmade essential items for those who suffer from natural disasters, human injustices, and unforeseen tragedies beyond their control.

To participate in one of our service activities, fill out the form below. Please note that by filling out this form you agree to receive emails from Stitching Hearts Worldwide. Thank you for your service, together we can make a difference.

If you have any questions, please contact us at events@stitchingheartsww.org
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Are you over the age of 18? *
First Name *
Last Name *
Email *
Phone *
Address *
City *
State *
Zip *
Media Release:  I hereby authorize Stitching Hearts Worldwide (SHW) to use my picture, likeness, and/or information related to this service event I choose to participate in for SHW.  I understand this information may be used in publications, including electronic publications, social media, audiovisual presentations, promotional literature, advertising, community presentations, etc. We will never disclose names along side of the picture, unless previously given permission to do so. My consent is freely given as a public service to SHW, without expecting payment. I release any SHW and their representatives from any and all liability which may arise from the use of such news media stories, promotional materials, written articles, videotape and/or photographs. *
Liability Release:  I agree to follow all safety precautions as explained to me. I agree to not hold Stitching Hearts Worldwide, it's Board Members, or volunteer staff legally liable for injuries or damages that may occur. *
Emergency Contact's Name *
Emergency Contact's Phone Number *
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