Rebuilding Together, Inc. Home Repair Project
National Rebuilding Day  – Chicago and Robbins, Illinois – April 29, 2017

Please read and fill out the form below to register your child to volunteer on National Rebuilding Day.

In consideration of the opportunity afforded my (our) child to assist on a voluntary basis in the Rebuilding Together, Inc. (including its local affiliate, Rebuilding Together * Metro Chicago) National Rebuilding Day Project in which the homes of disadvantaged persons will be repaired by volunteers, and in light of the aims and purposes of the community service provided by Rebuilding Together * Metro Chicago in organizing this project, I (we) hereby give my (our) permission for my (our) child to participate in the National Rebuilding Day Project, and I (we), (including my (our) successors, assignees, heirs, guardians and legal representatives) on behalf of my (our) child and myself (ourselves), waive any right of cause of action arising as a result of my (our) child's participation (in whole or in part) in said project from which any liability may or could accrue against Rebuilding Together, Inc., Rebuilding Together * Metro Chicago, Malcolm X College, the City of Chicago, the County of Cook, the Village of Robbins, National Rebuilding Day Project Sponsors, and their respective officers, directors, agents, vendors, employees, contractors, and staff collectively or individually.  Without limiting the generality of the foregoing, I (we), on behalf of my (our) child and myself (ourselves), agree that this waiver shall include any rights or causes of action resulting from personal injury to my (our) child, to others, or damage to my (our) child's property (or the property of others) including damage to (or injuries arising out of) automobiles, vans, trucks, buses, or other modes or transportation to or from Malcolm X College, or to individual Project sites, sustained in connection with my (our) child's activities (either in whole or in part or during) the National Rebuilding Day Project.  I do hereby grant and convey unto Rebuilding Together and/or any person authorized by them all rights, title, and interest in any photographs, recordings, interview, videotapes, motion pictures or similar visual or auditory recordings made by Rebuilding Together during my (our) child’s activities with respect to the project, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Child's Name *
Child's Name
(Notwithstanding this agreement, Rebuilding Together * Metro Chicago requires that all volunteers be at least 14 years of age)
Parent Name *
Parent Name
Parent Daytime Phone *
Parent Daytime Phone
Parent Evening Phone
Parent Evening Phone
Acknowledgement *
I (we) hereby give my (our) permission for my (our) child to participate in the National Rebuilding Day Project, and I (we), (including my (our) successors, assignees, heirs, guardians and legal representatives) on behalf of my (our) child and myself (ourselves), waive any right of cause of action arising as a result of my (our) child's participation (in whole or in part) in said project from which any liability may or could accrue against Rebuilding Together, Inc., Rebuilding Together * Metro Chicago, Malcolm X College, the City of Chicago, the County of Cook, the Village of Robbins, National Rebuilding Day Project Sponsors, and their respective officers, directors, agents, vendors, employees, contractors, and staff collectively or individually.