2016 Individual Teen Sign-Up Form
TEENS MAKE A DIFFERENCE DAY- SATURDAY OCTOBER 29TH, 2016
PROJECTS TO BE COMPLETED: 9:00 a.m. -12:00 p.m.
FREE PIZZA LUNCH AND GIVE AWAYS: CENTRAL BOYS & GIRLS CLUB:12:00 p.m. -1:00 p.m.

Forms Due by October 17th.

Do you have a teen or are you a teen that would like to take part in their community? Fill this form out and we will place your teen or teens up with a group around their age range and/or same school your child attends (unless otherwise requested and if a group from that school is available) then pair them with a project.

Parent / Gaurdian Name:
First and Last Name
Your answer
Parent / Guardian Cell #:
Must have cell # for Emergency purposes
Your answer
Email Address:
Your answer
Address:
Street, City, State, Zip
Your answer
Your Teens Name:
First and Last Name
Your answer
Teens T-Shirt Size
Your Child's Shirt Size
School Teen Attends:
Your answer
Grade with age:
6th grade, 7th grade, Senior .... etc with age of youth.
Your answer
Will parent / guardian be participating?
If yes to above, give T-Shirt Size
Your Shirt Size if planning on volunteering as well
Comments/Other:
Your answer
Photo Release
***PHOTO RELEASE Attendance and/or participation in the program and event, “Teens Make a Difference”, grants The Nonprofit Center permission and release to record images of any person and use said imagery with or without an associated name in distribution for any lawful purpose, including, but not limited to, publicity, illustration, advertising and web content. 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 The Nonprofit Center as well as indemnifies The Nonprofit Center, its board, staff, agents and volunteers against any and all recourse resulting from said attendance or participating activity.***
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