Issue link: http://townofcary.uberflip.com/i/964971
26 www.townofcary.org Membership Application 2018-2019 Membership Applications will be accepted beginning June 1. Register using course code 115122 or mail to: Cary Teen Council Herbert C. Young Community Center 101 Wilkinson Avenue, Cary, NC 27513 For more information, contact Doug Peters at doug.peters@townofcary.org or by phone at (919) 460-4965. Name: Male Female Date of Application: Birth Date: Returning Member: Yes No Address: City: Zip: Phone #: Email: Parent Email (if you wish to receive communication) Name of Parent(s)/Guardian(s): Name of School 2018-2019: Grade 2018-2019: 9 10 11 (Seniors not accepted as new members) Fees: Cary Resident $25 (Make Checks payable to Town of Cary) T-Shirt Size (adult sizes): Small Medium Large X-Large XX-Large New Member Mandatory Meeting All NEW members must attend a new-member meeting prior to volunteering. No refunds if requirement is not met. I will attend on the following date, 6 p.m. at Herb Young Community Center: Tuesday, June 12 Tuesday, July 10 Tuesday, August 14 No one on one assistance will be provided for volunteer work. Individuals requiring a higher level of support may volunteer if they have a personal assistant. Teen Council meets on the 3rd Tuesday each month beginning in August Consent and Waivers I certify 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 Minors 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 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: Email List Address List Attended New Member Meeting E S TA B L I S H E D 1 9 8 9