Volunteer Enrollment Form
Please complete this form at least one week prior to a field trip, start of a sport, etc.
Sign in to Google to save your progress. Learn more
Email *
Last name *
First name *
Phone number *
Email address *
Emergency contact name *
Emergency contact phone number *
Medical information that needs to be relayed to Emergency First Responders, if applicable.  Enter N/A if not applicable. *
Volunteering for (check all that apply) *
Required

By checking this box I certify that I have read, understand and will comply with the rules, regulations, and expectations of Immanuel Lutheran Church, School and Child Care.  I understand that the Volunteer Handbook is a guide, may be updated at any time, and can be found online at immanuelbrookfield.org. 

 *
Required

By checking this box, I authorize ambulance transportation and all treatment as deemed necessary by emergency medical personnel in the event that I am unable to communicate.

 *
Required

By checking this box I acknowledge that unexpected situations arise that are not within the control of Immanuel Lutheran Church, School and Child Care.  I agree to release and hold harmless Immanuel Lutheran Church, School and Child Care and it’s representatives from any and all liability, claims, suits, demands, judgments, costs, interest and expense arising from such activities, including any accident or injury to myself. 

*
Required

By checking this box, I understand that photos and videos may be taken by Immanuel representatives in the course of normal activities.  I give permission for Immanuel Lutheran Church, School and Child Care to use pictures and/or video of me without compensation.  I release Immanuel Lutheran Church, School and Child Care from any liability arising from the use of any photograph, video or other image of myself.

*
Required

Sign this form using keypad and submit form.

 *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Immanuel Lutheran School.

Does this form look suspicious? Report

Google Forms