Issue link: http://townofcary.uberflip.com/i/303177
Cary Parks, Recreation & Cultural Resources page 17 And the Winner is…… Cary Teen Council Established 1989 Membership Applications accepted in June only. Register using course code 77592 or mail to: CARY TEEN COUNCIL c/o Cary Parks, Recreation and Cultural Resources Department P.O. Box 8005 • Cary, N.C. 27512-8005 For more information, contact Korey Sullivan at (919) 460-4965 or email at korey.sullivan@townofcary.org. MEMBERSHIP APPLICATION Name: ________________________________________________________________________ o Male o Female Date of Application: __________________ Date of Birth: ____________________ Returning Member Yes o No o Address: ______________________________________________________________________________________________________ City: ______________________________________________________ State: ______________ Zip: ________________________ Teen Email: ________________________________________________________________________________________________ Parent Email (if you wish to receive information): ________________________________________________________________ Name of Parent(s) or Guardian(s): _____________________________________________________________________________ School 2014-2015: __________________________________________________________________________________________ Grade 2014-2015: (circle) 6th 7th 8th 9th 10th 11th (Seniors no longer accepted as new members) Fee: o $20 Cary Residents o $30 Non-Resident T-SHIRT SIZE (ADULT SIZE): o Small o Medium o Large o XL o XXL CONSENT and WAIVERS I certify that the above information is true and complete to the best of my knowledge. I am aware that certain portions of this information may be subject to disclosure under the NC Public Information Disclosure laws. Volunteer's Signature __________________________________________________ Date _____________________ PARENTAL CONSENT FOR MINOR TO VOLUNTEER: In consideration of the Town of Cary, permitting my child to participate as a volunteer in the Parks, Recreation & Cultural Resources department and its associated activities, I acknowledge and agree to the following: (1) I represent that my child is in satisfactory physical and mental health, physically/mentally able to engage in volunteer work, and is not a danger to themselves or others, (2) I am aware that I will be held liable for any misconduct or behavior or unlawful activity that my child may engage in while in a volunteer status with the Town of Cary. (3) I authorize my child to maintain an account on the Cary Teen Council website, to be used solely for its intended purpose. Parent/Guardian Signature _____________________________________________ Date _____________________ For Office Use Only: o E-mail List o Address List o Attended new member meeting New Member Mandatory Meeting: I will be attending on the following date: o Wednesday, June 25 o Thursday, July 17 o Thursday, August 7 Teen Council meets on the 3rd Tuesday of each month beginning in August *All new members must attend a new member meeting prior to volunteering. No refunds if this requirement is not met.