Form

Build walls for Habitat Homes - on Madison Green

Must be age 16 or older for this activity. If you are under age 18, print out the Waiver of Liability form to be signed by a parent or guardian. Bring it with you on May 11.
Click HERE to download the '2013 Waiver of Liability' form
Please fill in, especially "required" fields, so we can process your registration. If you experience a problem, email "madisoncareshabitat@gmail.com".
Full Name of Volunteer - Required*
First Name Last Name
Birth Date if under age 18
Month Day Year
Second Family Member (if applicable)
First Name Last Name
Birth Date if under age 18
Month Day Year
Third Family Member (if applicable)
First Name Last Name
Birth Date if under age 18
Month Day Year
E-mail - required*
Confirm E-mail - required*
Phone # on May 11 - required*
- Area Code Phone Number
Town
Tell us if you are volunteering with a group
Tell us if you prefer non-construction work on the Green - must be at least in high school
If you are not volunteering with a group, choose your preferred work shift below. One work shift per person.
Work shifts

8:00 - 9:30 am 9:30 - 11:00 am 11:00 - 12:30 1:30 - 3:00 pm
Voluntary Donation
Your voluntary donation helps pay for Madison Cares' 9th Habitat home. A donation of $25 per adult (age 18 and older) and $15 per teen comes with a 2013 custom event t-shirt. DONATE NOW thru the secure online account of Habitat for Humanity of Greater New Haven . Just click on the "Donate" button (upper left corner) to use your credit card or PayPal account. DON'T FORGET TO RETURN TO THIS FORM TO 'SUBMIT REGISTRATION' . Thank you!
Questions about registration?
Please type question. Then click on "Submit" button, below
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Build walls for Habitat Homes - on Madison Green

Please fill in, especially "required" fields, so we can process your registration. If you experience a problem, email "madisoncareshabitat@gmail.com".

If you are not volunteering with a group, choose your preferred work shift below. One work shift per person.

Voluntary Donation

Questions about registration?