Seniors Helping Seniors

Plain-O Helpers Volunteer Application and Hold Harmless Form

Thank you for willing to volunteer your time to help the seniors in Plano! Please complete the form below and click on the Submit button.  Someone from Plain-O Helpers will be in contact with you soon!

Name(s):

Address:

City:

State:

ZIP:

Home Phone:

Cell Phone:

Email Address:

Date of Birth:

Church Membership (or Unaffiliated):


In consideration of Plain-O Helpers' acceptance of this entry in the program, the above named VOLUNTEER(S) hereby agree to perform minor home repair and maintenance projects as part of the program and in accordance with the recommendation of the Plain-O Helpers Steering Committee and/or their designees. The VOLUNTEER(S), by submitting this form, state that they are aware that the property may contain hazardous conditions.

The VOLUNTEER(S), assume the responsibility and risk of all conditions, hazards and potential dangers in, on or about the property whether they are open and obvious or concealed. The VOLUNTEER(S) HEREBY RELEASE, DISCHARGE AND WAIVE any claims, actions or suits of any character, named and description against Plain-O Helpers or their officers, agents and/or employees and the owner(s) and/or residents of the property as a result of any injuries and death received or sustained by VOLUNTEER(S) presence on the property.

The VOLUNTEER(S), by clicking on this box and submitting this form, state that they have read and fully understand this agreement, and have not been offered any additional consideration or enticement, nor have they been coerced to execute same, and the VOLUNTEER(S) execute this agreement fully for the purposes and considerations expressed herein.

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