Morty’s Kids @ OSU Volunteer Registration

PGM Students and Staff: please complete this form for your involvement with Morty’s Kids @ OSU. The 2009 program will be held each Tuesday afternoon March 31, 2009 – May 19, 2009.
If you are unable to attend on your assigned date, it is your responsibility to find a replacement (a contact list is available in the PGM office).

Your Name

Mailing Address

City

State

Zip Code

Day Phone

Evening Phone

Please Check One:

PGM Student
PGM Staff
Morton Foundation Volunteer

Please select the dates that you plan to attend:

March 31
April 7
April 14
April 21
April 28
May 5
May 12
May 19

If you did not receive one of our golf shirts last year or no longer have yours, please indicate your shirt size so we can order one for you:

S
M
L
XL
XXL

I consent to having sound recordings, photography and/or videotape take of me and used by The Morton Foundation and/or news media for informational, educational, and/or promotional purposes.

Yes
No

By submitting this form, I certify that all information I have provided is correct and that I am physically fit to supervise and participate in golf activities. Also, I do hereby, for myself, executors, administrators, and person, waive, release and forever discharge any and all rights and claims for damages which may occur or which may hereafter occur to the person against The Ohio State University or Morton Foundation volunteers, respective officers, board members and agents and/or assign for any and all damages which I may attain.