What's your email address?

Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, Northwest Arkansas Food Bank will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Birth Date *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Address *
Address (Line 2)
City *
State *
Zip Code *
Emergency Contact Name *
Emergency Contact Number *
Are there any medical conditions or limitations we should be aware of?
Employer
Are you volunteering to fulfill Court-Mandated hours? *
REQUIRED APPLICATON: Please fill out application following this link:
Court Mandated Application
How did you hear about our volunteer program?





Waiver


Who is this registration for?

I understand that it is prohibited for me to remove any NWA Food product or confidential information (files, forms, emails other written or electronic documentation, etc.) for any personal use. I give the Northwest Arkansas Food Bank permission to conduct a background check on me prior to or during my volunteer service. I understand that volunteer service is at will and can be terminated for any reason and/or for an undisclosed reason with or without advance notice at any time. The policies relating to volunteers are intended as guidelines for volunteers and are subject to change at the sole discretion of The Northwest Arkansas Food Bank.

 

Release for Volunteers & Model Release and Consent Agreement

I, the undersigned, requests permission to enter the Northwest Arkansas Food Bank, a Feeding America Food Bank, including but not limited to the offices and warehouse and to participate in volunteer activities. I know the risks of injury to my person and property that may be sustained in connection with the stated and associated activities, in and about the premises.

 In consideration of the permission granted to me to enter the premises and participate in the stated activities, I, for myself, my heirs, administrators, and assigns, release and discharge the owners, operators, and sponsors of the premises, activities, and vehicles and equipment in the stated activities of and form the premises and my participation in the stated activities due to negligence or any other fault.

I represent and certify that my true age is 18 years or over, I certify that my attendance and participation of the stated activities is voluntary, and that I am not, in any way, the employee or agent of the owner, operators, or sponsors of the premises and the activities, vehicles and equipment, in the same.

I, the undersigned, hereby irrevocably consent to the unrestricted use by the Northwest Arkansas Food Bank and/or its clients, customers, successors and assigns and those acting under its authority, and those for whom it is acting, the absolute right, for as long and as often as they may elect to copyright and/or use and/or publish any media pictures of me and in which I may be included in whole or in part, whether such pictures may be retouched, otherwise changed in character or form, or included as part of a composite picture in conjunction with my character or form, or included as part of a composite picture in conjunction with my own or fictitious name or reproductions or versions thereof in color otherwise, made through any media on or about me for art, advertising, trade or any other lawful purpose whatsoever. I hereby waive any right to inspect or approve the finished photograph, advertising copy, or printed matter that may be used in conjunction there with, or to the eventual use that it may be applied. In conjunction with the foregoing, I hereby release and hold harmless. The Northwest Arkansas Food Bank and each of the above from all-liability. I hereby warrant that I am providing modeling services as a professional, freelance and/or independent contractor. The Northwest Arkansas Food Bank nor Northwest Arkansas Food Bank staff members are liable for any injuries that may occur while volunteering. This agreement constitutes the complete and exclusive agreement between me and The Northwest Arkansas Food Bank and I am not relying on any other representation whether oral or written.