Brush Up Mac
A Service Program of McPherson Housing Coalition, Inc.
1826 14th Ave -  McPherson, KS 67460  
(620) 241-7828 x 16

April 30, 2022
(All volunteers must be at least 14 years of age unless supervised by an adult)

I WANT TO VOLUNTEER!
Please Print
Name:_______________________________________Organization/Team:________________

Address:_________________________________City____________  Zip________________

Cell Phone: ________________  Email:_______________________________________

You will receive a t-shirt for volunteering your time.  Please indicate your size preference.

_____S	_____M	______L	_____XL	____XXL  ____ larger Size

In consideration of the opportunity afforded me to assist on a voluntary basis in the Brush Up Mac area home repair project, a project in which the homes will be repaired by volunteers, and in light of the aims and purposes of the community service provided by Brush Up Mac in organizing this project, I waive any right or cause of action arising as a result of my participation in said project from which any liability may or could occur against Brush Up Mac or its officers and directors collectively or individually.  Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damages to my property sustained in connection with my activities from the Brush Up Mac project.

Please Print

Date___________Volunteer________________________________________________

Signature of  Volunteer_____________________________________________________

If under the age of 18 – Parent Signature:______________________________________

In case of emergency please contact:__________________________________________

Phone________________________________Relationship________________________
(Over)
Please make copies of this form and waiver and mail to the above address before March 15th, 2022.  
Thank you for your support.     

I can help:    _______ or _________

Unskilled Labor:
_______	I am willing and able to work but have no specific skills.

_______	I am willing and able to work and can do__________________________

Skilled Labor
_______	Carpentry	_______Electrical	_______Yard Work	______Other

_______	Hearing/AC	_______Plumbing	_______Roofing    ______Painting

Other

_______	I would like to volunteer my time to help before the event
			
Donations

______	I would like to make a cash donation.  Enclosed is a check for $_______
		(Make checks payable to McPherson Housing Coalition)

_______	I would like my name/business to be on the event T-Shirt ($100 suggested donation)					______________________________________________.
Supplies Needed:

_______	Caulking	________	Electrical Materials	______Other

_______	Garden Tools	________	Hand Tools		_______ Lumber

_______	Drop Cloths	________	Cleaning Supplies	_______Trash Bags

_______	Paint Brushes, Rollers & Pans	_______	Exterior Paint (latex)