Individual 4Cs Cares Day Registration Form

Name

Phone

This address will receive a confirmation email

May we text you?

Yes No

Best Way To Reach You

Email Phone Text

Project Interest 1st Choice

Experience Level for 1st Choice

Project Interest 2nd Choice

Experience Level for 2nd Choice

I would consider serving as a Crew Leader

I would like to be involved in on-going projects.

Emergency Contact: In the event I suffer an injury or condition during my participation in the Activities, including transportation to and from the Activity. Please contact the person(s) listed below.

Please provide 2 contacts in the event we are unable to reach your primary emergency contact.

Primary Emergency Contact Phone Number

Secondary Emergency Contact Phone Number

GENERAL ADULT RELEASE AND HOLD HARMLESS AGREEMENT: I desire to participate in various programs, events or activities involving work efforts relating to 4CsCares Day (hereinafter collectively referred to as the “Activities”) operated or sponsored by 4Cs (the Church). I understand and acknowledge that the Church will not allow me to participate in the Activities without releasing and holding the Church harmless from any liability arising out of my participation in the Activities. I have investigated the risks involved in my participation in the Activities and fully understand and assume such risks. Specifically, I understand and acknowledge that I may suffer or experience, among other things, personal injury or bodily damage, personal illness, medical disabilities, loss or theft of personal property, imprisonment, abduction and even death. I request that the Church allow me to participate in the Activities, and in consideration thereof agree hereby to release and forever discharge the Church, its officers and directors, and its employees, agents, and any parties volunteering on behalf of the Church, from all actions, causes of action, injuries, claims, damages, costs or expenses of any kind, including any negligence of the Church, growing out of or related to any such Activities in which I participate. I understand that this is a full and complete release of all injuries and damages, which I may sustain as a result of my participation in any of the Activities, regardless of the specific cause thereof. By typing your name below, each party confirms that they are intending to be legally bound by this agreement.

I hereby grant 4Cs and its representatives’ permission to use for this and any event until rescinded by me, without compensation or restriction, photographs and videotape images in which the participant appears, in any manner whatsoever such as, but not, limited to: publication, display, advertising, slide shows, etc. By typing your name below, each party confirms that they are intending to be legally bound by this agreement.

Questions/Comments:

Payment

Cash Donations are needed to cover cost of t-shirts, food, and project supplies. Suggested donation per volunteer is $14/$42 max per family. If paying with scrip, please contact Jim.Auslen@4Cs.Church or Joanne.Thoutt@4Cs.Church

Donation Amount

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

September 7, 2025

This form is for volunteers who want to register individually, not as a couple or family. If you need to register more than one adult and/or child(ren) please complete the Multi-person/Family Registration form.

Submit your volunteer application early! Volunteer count drives what projects we can accept!
Please complete for each volunteer that will be participating in 4Cs Cares Day 2025.

If you would like to donate with Scrip, email Jim.Auslen@4cs.church or Joanne.Thoutt@4cs.church. If you would like to donate at a later time you may pay with cash or check in your regular offering by designating on your envelope "4Cs Cares Day" or visit our website, 4Cs.Church/Give, and choose "4Cs Cares Day Donation" in the fund drop down box.

Suggested donation per volunteer is $14.00 ($42.00 max per family). Donations are needed to cover the cost of t-shirts (t-shirt orders must be received by August 4), food, and project supplies.

Questions: Please contact Joanne Thoutt at Joanne.Thoutt@4Cs.Church.
Thank you for joining the 4Cs Cares Day Team!

***Upon successful completion of the form you will receive the message "Thank you! You have successfully filled out this form." If you do not see this message, please scroll up to see what fields need to be completed (these fields should be highlighted in red.)*** You will also receive a confirmation email.
Please fill out this form and click submit.

Individual 4Cs Cares Day Registration Form

Description

Please Fix the Following