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North Reading Youth Services

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Shovel Registration

Text Box: Pay Your Respect and Shovel a Vet North Reading Youth Services & Veterans Services Snow Shovel Volunteer Intake Form By completing the information below, I understand that I am interested in volunteering my time to shovel snow for the seasoned Veteran’s of North Reading residents. NAME: _____________________________________________ ADDRESS: __________________________________________ ____________________________________________________ AGE/GRADE:_________________________________________ PHONE NUMBER: ____________________________________ ALTERNATIVE NUMBER: ______________________________ EMAIL: _____________________________________________ YOUR AVAILABILITY: _________________________________ ARE YOU ABLE TO BRING A SHOVEL: ___________________ INTERESTED PARENT/GUARDIAN(S):____________________ ____________________________________________________ Hold Harmless I hereby agree I will indemnify and hold the Town of North Reading, MA harmless of and from any and all claims that may be made by any person or organization for personal injury or property as a result of my child’s participation in the ‘Pay Your Respect and Shovel a Vet’ shovel volunteer program. ______________________________________ ________________________ Parent Signature Date