Goodwill Tenneva Processing Center 2745 East Stone Drive Kingsport, TN 37660
Participant's Name (Required)
Participant's School (Required)
Age: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I am or will be 16 years of age or older as of Saturday, April 2, 2022.
Safety and Security: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I will follow all safety and security procedures and protocols as instructed by Goodwill staff and/or workstation supervisors during Goodwill Day 2022. These include but are not limited to observing all COVID-19 related safety measures and mask guidelines, wearing appropriate closed footwear (no bare feet, flip flops, sandals, or heels), and removing any technology (such as ear buds) that may prove distracting while at the workstations. Proof of identity (photo ID) is required for check-in at Goodwill Day 2022. Lunch will be provided during Goodwill Day 2022.
Do you have any physical work limitations? YesNo
If Yes, please list the limitations and requested accommodations at Goodwill Day 2022:
Please list any environmental allergies and/or food restrictions:
Emergency Contact Information: (Name and Phone Required)
Media Release: This statement certifies that I and/or my parent/legal guardian (if applicable) grant Goodwill Industries of Tenneva Area, Inc. the right and permission to take and use photographs, videos, and/or audio recordings of me related to my experience at Goodwill Day 2022 for news, publicity, social media, advertising, and other informational purposes. This statement certifies that Goodwill may use such images of me with or without my name and for any lawful purpose.
Liability Release: This statement certifies that I and/or my parent/legal guardian (if applicable) release Goodwill Industries of Tenneva Area, Inc. from any liability due to personal injury, illness, or damage to any personal property while completing community service requirements during Goodwill Day 2022 at the Processing Center, Kingsport, location of Goodwill Industries of Tenneva and/or at any work station to which I am assigned during Goodwill Day.
By typing a digital signature(s) below and clicking to submit this form, I and/or my parent/legal guardian (if applicable) acknowledge and agree to all terms and conditions of community service during Goodwill Day 2022 hosted by Goodwill Industries of Tenneva Area, Inc.
Digital Signature of Participant (Full legal name required)
Age of Participant as of April 2, 2022 (Required)
Confirm Email on File with Volunteer Services (Required)
Digital Signature of Participant’s Parent or Legal Guardian (Full legal name required if participant is less than 18 years of age as of today or subject to a legal guardianship)
Parent or Legal Guardian’s Email (Required)
Are you the participant’s parent or legal guardian? ParentLegal Guardian
Today's Date (Required)
Online Form Authorized 01/22
