WAITLIST APPLICATION 

Personal Info
Participant Name *
Participant Name
Birthdate *
Birthdate
Co-participant
Co-participant
Home/Project Address *
Home/Project Address
Participants must reside within the I275 loop.
CONTACT INFO
Phone
Phone
Contact Preference
Project Info
TERMS AND CONDITIONS
DISCLOSURE *
RETIRE REPAIR is a community building organization with the purpose of civic engagement and informal knowledge exchange. RxR is not a licensed, bonded and insured trade entity.
RISK AND LIABILITY *
Construction is a hazardous and potentially dangerous activity. Engaging in such activity and relative activities may result in illness, severe injury or death.
PHOTO RELEASE *
Photographic, audio and/or video recordings may be collected and used for online, educational, and/or promotional purposes.
OTHER RESPONSIBILITIES *