Global Youth Service Day
Group Registration Form
Individual Registration Form
______________________________________________ Group Name
______________________________________________ Name
______________________________________________ Contact Name (21 years or older)
______________________________________________ School
______________________________________________ Contact Phone Number
______________________________________________ Address
______________________________________________ Contact Email Address
______________________________________________ City/Town
Name, Age
______________________________________________ State Zip Code
Daniel P. McCoy Albany County Executive
Paula Mahan Colonie Town Supervisor
__________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______
______________________________________________ Telephone ______________________________________________ Age Email
Global Youth Service Day
__________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______
If registering for a group you must collect signed photo and parental consent forms for your group. If you need more space, please use your own paper and attach to this form.
Albany County Department for Children Youth and Families - Youth Bureau 112 State Street Albany, NY 12207 Attention: Nicole Ward (518) 447-4892 or email [email protected] Town of Colonie Youth Services 580 Albany Shaker Road Loudonville, NY 12211 Attention: Laura Archambault (518) 783-2760 ex # 2101 [email protected]
Saturday, April 28, 2018 Service Projects: 9:00am - 12:00 noon (unless otherwise noted) Celebration to follow: 12:30pm West Albany Memorial Park 110 Braintree St, Albany NY 12205
Registration deadline is: Thursday, April 17, 2018
Thank you for your interest in
Global Youth Service Day on Saturday, April 28, 2018.
How can I get involved?
How Do I Sign Up? STEP 1: Select your top two choices from the project list to the right. If you are not placed in either of these projects we will contact you to schedule another service site. STEP 2: Complete either the individual or group registration form. STEP 3: Make sure you sign the release form. If you are 17 or younger, have parent/guardian sign it. Email the registration and release form. STEP 4: Mail/fax the registration and release forms to: Town of Colonie Youth Services 580 Albany Shaker Road Loudonville, NY 12211
Service Projects Please select your top 2 desired projects from the list below. Mark number “1” next to your first choice and “2” next to your second choice. ____ American red Cross (5-10 Youth) ____ Albany County Nursing Home 10:00am - 12:00 (arts & crafts with seniors)
____ Beltrone Senior Living Center (spring clean-up)
____ Canal Sweep - Mohawk River Bike Path (spring Clean-Up) ____ Damien Center (spring clean-up) ____ The Crossings Park (Spring clean-up) ____ Eagan Park (spring clean-up) ____ Loudonville Green Park (spring clean-up) ____ Habitat for Humanity Restore (must be 14 & parent must accompany 14 & 15 year olds) (Indoor clean-up) 10:00am -12:00pm
Release Form/Parental Consent for Minors All volunteers must complete the release form. If you are 17 years of age or younger, please have your parent/guardian sign the Parental Consent Form on the bottom of this page.
The Albany County Youth Bureau and Town of Colonie Youth Services is requesting your consent to allow your child ____________________________to participate in Global Youth Service Day along with the use of your child’s photo publically. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. LIABILITY RELEASE: In consideration of Albany County and the Town of Colonie allowing the Participant to participate in GYSD I, the undersigned, do hereby release, forever discharge and agree to hold harmless Albany County/Town of Colonie directors, employees, volunteers and teachers from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the GYSD activities.
____ Capital Rescue Mission (kitchen help) ____ Ronald McDonald House
_____________________________________________ Participant Name
(baking– provide baking supplies)
Attention: Laura Archambault [email protected] Fax (518) 380-5152 If you have any questions, please call Laura (518) 783-2760 ext. 2101 or Nicole (518) 447-4892
____ Palma Park (spring clean-up) ____ Pruyn House (spring clean-up) ____ Regional Food Bank (Warehouse sorting)
____ Regional Food Bank (Garden– Spring clean-up)
_____________________________________________ Print Name of Parent/Legal Guardian (child under 17)
____ Salvation Army (background check required must sign-up prior to April 1st)
You will be contacted before Global Youth Service Day to verify participation and to answer any questions you may have.
_____________________________________________ Participant Signature (If 17 or older)
PLEASE NOTE: We do our best to place you in your desired project, but need to make sure all projects have enough volunteers. Please register early to have a better chance of getting your first choice. Safety is extremely important. Please dress appropriately and wear close-toed shoes!
_____________________________________________ Signature of Parent/Legal Guardian _____ Yes, I give permission for my child’s photograph to be used. _____ No, I DO NOT give permission for my child’s photograph to be used.
Individual Registration Form
______________________________________________ Group Name
______________________________________________ Name
______________________________________________ Contact Name (21 years or older)
______________________________________________ School
______________________________________________ Contact Phone Number
______________________________________________ Address
______________________________________________ Contact Email Address
______________________________________________ City/Town
Name, Age
______________________________________________ State Zip Code
Daniel P. McCoy Albany County Executive
Paula Mahan Colonie Town Supervisor
__________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______
______________________________________________ Telephone ______________________________________________ Age Email
Global Youth Service Day
__________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______ __________________________________ Age: _______
If registering for a group you must collect signed photo and parental consent forms for your group. If you need more space, please use your own paper and attach to this form.
Albany County Department for Children Youth and Families - Youth Bureau 112 State Street Albany, NY 12207 Attention: Nicole Ward (518) 447-4892 or email [email protected] Town of Colonie Youth Services 580 Albany Shaker Road Loudonville, NY 12211 Attention: Laura Archambault (518) 783-2760 ex # 2101 [email protected]
Saturday, April 28, 2018 Service Projects: 9:00am - 12:00 noon (unless otherwise noted) Celebration to follow: 12:30pm West Albany Memorial Park 110 Braintree St, Albany NY 12205
Registration deadline is: Thursday, April 17, 2018
Thank you for your interest in
Global Youth Service Day on Saturday, April 28, 2018.
How can I get involved?
How Do I Sign Up? STEP 1: Select your top two choices from the project list to the right. If you are not placed in either of these projects we will contact you to schedule another service site. STEP 2: Complete either the individual or group registration form. STEP 3: Make sure you sign the release form. If you are 17 or younger, have parent/guardian sign it. Email the registration and release form. STEP 4: Mail/fax the registration and release forms to: Town of Colonie Youth Services 580 Albany Shaker Road Loudonville, NY 12211
Service Projects Please select your top 2 desired projects from the list below. Mark number “1” next to your first choice and “2” next to your second choice. ____ American red Cross (5-10 Youth) ____ Albany County Nursing Home 10:00am - 12:00 (arts & crafts with seniors)
____ Beltrone Senior Living Center (spring clean-up)
____ Canal Sweep - Mohawk River Bike Path (spring Clean-Up) ____ Damien Center (spring clean-up) ____ The Crossings Park (Spring clean-up) ____ Eagan Park (spring clean-up) ____ Loudonville Green Park (spring clean-up) ____ Habitat for Humanity Restore (must be 14 & parent must accompany 14 & 15 year olds) (Indoor clean-up) 10:00am -12:00pm
Release Form/Parental Consent for Minors All volunteers must complete the release form. If you are 17 years of age or younger, please have your parent/guardian sign the Parental Consent Form on the bottom of this page.
The Albany County Youth Bureau and Town of Colonie Youth Services is requesting your consent to allow your child ____________________________to participate in Global Youth Service Day along with the use of your child’s photo publically. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. LIABILITY RELEASE: In consideration of Albany County and the Town of Colonie allowing the Participant to participate in GYSD I, the undersigned, do hereby release, forever discharge and agree to hold harmless Albany County/Town of Colonie directors, employees, volunteers and teachers from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the GYSD activities.
____ Capital Rescue Mission (kitchen help) ____ Ronald McDonald House
_____________________________________________ Participant Name
(baking– provide baking supplies)
Attention: Laura Archambault [email protected] Fax (518) 380-5152 If you have any questions, please call Laura (518) 783-2760 ext. 2101 or Nicole (518) 447-4892
____ Palma Park (spring clean-up) ____ Pruyn House (spring clean-up) ____ Regional Food Bank (Warehouse sorting)
____ Regional Food Bank (Garden– Spring clean-up)
_____________________________________________ Print Name of Parent/Legal Guardian (child under 17)
____ Salvation Army (background check required must sign-up prior to April 1st)
You will be contacted before Global Youth Service Day to verify participation and to answer any questions you may have.
_____________________________________________ Participant Signature (If 17 or older)
PLEASE NOTE: We do our best to place you in your desired project, but need to make sure all projects have enough volunteers. Please register early to have a better chance of getting your first choice. Safety is extremely important. Please dress appropriately and wear close-toed shoes!
_____________________________________________ Signature of Parent/Legal Guardian _____ Yes, I give permission for my child’s photograph to be used. _____ No, I DO NOT give permission for my child’s photograph to be used.
