Official Use DASCO # DATE ASSIGNED: __________
YOU or YOUR Group Leader MUST attend the DO-A-THON Orientation on July 20th at 2020 NW 1st Avenue – Miami, starting at 10AM. T-Shirts will be provided (There are TEAM colors) DATE OF APPLICATION: _____/____/____ INDIVIDUAL or GROUP NAME: ADDRESS:
CITY & STATE:
CONTACT PERSON:
E-MAIL ADDRESS:
CONTACT PHONE 1: (___)
CONTACT PHONE 2: (____)
BUSINESS PROFESSION:
This goes directly to purchasing food to feed over 2,000 homeless men, women and children NAME (First and Last)
AGE T-Shirt SIZE
NAME (First and Last)
AGE
T-Shirt SIZE
_ _ _ _ _ _ _ _ _ _
__ __ __ __ __ __ __ __ __ __
Confidentiality Statement: Information concerning donors, clients, employees or fellow volunteers must be treated as strictly confidential. Release of confidential information by unauthorized personnel is grounds for immediate termination of the special event. Confidential information obtained in the course of an event, which is for personal gain, is in violation of our conflict of interest policy and will result in procedures against the said parties. Please be advised of the following conditions: 1. I (we) understand the Miami Rescue Mission (MRM) will be held harmless for any group or individuals harmed while on our property and that MRM is not responsible for property of said group or individuals. 2. I (we) understand all media inquiries must be referred to the Communication Department (305-572-2245). 3. I (we) hereby release and approve MRM to take photos of group or individuals while on the premise and to be able to publish them in all of our media output. 4. I (we) agree that any organization, group, or individual planning to hold a special fund raising event for Miami Rescue Mission must include the following statement on any publicity, flyers, posters or sign: This event is sponsored by (__________________________) for the benefit of Miami Rescue Mission. A portion of or the proceeds will benefit the Miami Rescue Mission. Your time of arrival for outreach (DO-A-THON) will be given to you by the Volunteer Coordinator 305-571-2227 Please arrive on time and report to your appointed team captain for instructions. – Thank you
Signature of Person in authority
Please Limit Group size to 20 Members
Date EMAIL or FAX all applications to: Lian Sarduy Volunteer Coordinator lsarduy@caringplace.org FAX: 305 571-2244 / Ph: 305-571-2227
Application Due: June 20th