New Orleans Rebirth Reservation Page

New Orleans Rebirth Volunteer Reservation Form

Yes! I want to help Community UU Church in its efforts in New Orleans this summer between July 28th and August 17th, 2013.

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Name (one per form, please):*
Best Telephone:*
Best Email Address:*
Gender:*
If youth, age at time of participation:
If youth, name of adult sponsor:

Congregation:*

Indicate if you are willing to drive your car to New Orleans (passengers will share in fuel costs):*	Yes No

Earliest travel date from Dallas/Fort Worth area(1):*
Latest travel date back to Dallas/Fort Worth area(1):*
Total days to spend (including travel):*

(1): If you have flexibility on the dates that you travel, this time window can be longer than you plan to participate. Please show this flexibility to help us plan transportation and ensure we have enough sleeping accommodations in New Orleans.

Explain any physical limitations you might have:

Type of work you would like to do:

Dietary Limitations:	Vegan (no animal products at all) Ovo-lacto vegetarian (eat eggs and dairy products but no other animal products) Vegetarian who eats fish, seafood, eggs, dairy Omnivore who eats no red meat (poultry, fish OK) Omnivore who eats "anything"

Any food allergies, important likes and/or dislikes:

Particular food you'd love to have in New Orleans:

	To prevent spam, please tell us: What is the sum of two and seven?*