Playhouse Project Application : Playhouse Project Information : Habitat for Humanity of Fulton County, Ohio

Online Playhouse Application

Parent(s) or Guardian(s) Name(s)

First Name *

Last Name *

Physical Address

Country

Address Line 1

Address Line 2

City

State/Province

Postal Code

Phone (Required)

Email (Required)

How did you hear about Playhouse Project? (Required)

Tell us about your children who would be receiving a playhouse (so we can build one they love): (Required)

Children's Names and Ages

Will the playhouse require any accessibility modifications? (Required)

For example, wheelchair access? If yes, please describe.

How would receiving a playhouse bless your family? (Required)

This information will help your sponsor understand how they are helping you and make it easier to design a playhouse for your family.

Give us Design Ideas for your Playhouse (Required)

What do your children like? Characters, letters, numbers, etc. Favorite colors? The more detail the better!

Note that design ideas are not guaranteed.

In order to partner with Habitat for Humanity of Fulton County, Ohio and be considered for a free playhouse through Playhouse Project, the following agreements must be made.

I Agree to Partner with Habitat for Humanity of Fulton County, Ohio in the Following Ways (#1-#4) and Understand the Following Important Requirements (#5-#11). I also Agree to the Media Release as Outlined.

(please check all after reviewing)

I agree that I will have my child(ren) at the Playhouse presentation (date/time TBD).

I would not ordinarily be able to provide a Playhouse for my child(ren).

I agree to pick up the Playhouse. If I am not able to pick up, I will notify Habitat immediately to help make arrangements. *Please note: your Playhouse cannot be delivered.

I agree to attend a Playhouse Project orientation meeting. Habitat will reach out to me to schedule.

I understand the size of the playhouse is 4’ wide x 5’ long x 6’ high and that it is made of wood. It is heavy and awkward. Habitat does not disassemble playhouses for pick-up and delivery. It will take 3-4 strong people to load and unload it.

I understand I will need a truck (many places rent these) to transport the playhouse (will not fit in vans)

I confirm I have space for it in the yard or garage and verified that it will fit through any doors or gates.

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If I rent my home, I confirm my landlord will allow a playhouse on the property. (N/A if you own but must still be checked).

I understand that the paint on the Playhouse may not be completely dry by the pick-up time.

#10

I understand that Habitat reaches out to many organizations to find sponsors to fund/build, and families to receive playhouses, and I may not receive one at the original specified date or location.

#11

I understand that I could be placed on a waiting list for when a playhouse is available. I understand that if a sponsor cannot be found, I may not receive a playhouse through Habitat’s program.

*Note: The media release (agreed to below) is outlined in full here:

Habitat requires a media release that gives permission to and assigns the right to use and reproduce family and/or child(ren)’s name, images, likenesses and/or voices in any and all forms of media including, without limitation, photographs, films, videos, tape recordings, and internet publications. Authorization is required for Habitat to use and distribute for any and all purposes, letters, stories, testimonials, other writings, quotations or verbal statements attributable to playhouse recipients and families. Recipient families will make no further claim of any nature because of or connected with said use of names, images/likenesses, written or verbal statements made.

I understand that the media may be present, and that I may be asked to speak to the media. If I am not comfortable speaking with the media, I will communicate this fact to Habitat staff before the presentation.

Habitat is very cautious when children are involved in our programs and projects and take utmost precautions to protect them. Our purpose is only to promote our programs so future families can have the same opportunity yours would through Playhouse Project.

Media Release:

Media Release: I give Habitat, its representatives, and Playhouse build sponsors permission to and assign the right to use and reproduce my family and/or child(ren)’s name, image, likeness and/or voice in any and all forms of media as outlined.*

Anything else you would like Habitat to know?

If you cannot/do not agree to all the above and digitally sign the application, Habitat will not be offering you a playhouse.

Habitat will contact you if a Playhouse Sponsor is determined. We will attempt to serve your family but do not make any guarantees of such.

We hope we can provide your family with a playhouse! Thank you.

Digital Signature (Required)

Typing parent/guardian name(s) here authorizes digital signatures

Date and Time of Digital Signature (Required)