UA Volunteer Registration

Volunteer Information
Name *

First Name Last Name
Birth Date *

Month Day Year
Phone

Area Code Phone Number
E-mail
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Areas of Interest

Youth Advisory Committee Member Fundraising Communications (Social Media, Online and Creative Writing) Outreach & Community Engagement CultureShock Community Arts Festival Administration Tutoring Board Member Photography Culinary Arts Video Production Spoken Word Visual Arts Events Music Dance
Number of Hours Available to Volunteer Each Week

1-5 5-10 10-15
When are you available to volunteer?
Do you have any needs that affect your volunteering?
Tell us more about why you wish to serve as a volunteer at UrbanArts
List the qualifications & skills that you bring to UrbanArts
Upload your resume
File size max 5MB
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship to volunteer *
Phone Number *

Area Code Phone Number
Alt. Phone Number

Area Code Phone Number
Media Release and Consent

I understand that photography/film/video may be used in the promotions of programs at UrbanArts. These may be published or used for any application in newspapers, films, television commercials, posters, online etc. or otherwise displayed to the public, or used for other educational/fundraising purposes either in whole or in part by UrbanArts.

I hereby consent to my child and/or me being photographed or videotaped during programs or activities hosted by UrbanArts and consent to the use of such images for the purposes expressed above and expressly release UrbanArts from all claims, legal or otherwise, thereof.
I agree

Yes No
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
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