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2. Please complete the form below to sign up for the Village's HELP Program. By completing the form you are acknowledging that you are registering for a voluntary program. With the submission of the form you agree to indemnify and hold harmless the Village of La Grange Park and its employees, officers, and appointed officials for any injury or damages which may arise as a result of my participation in the HELP program.
4. First Name*
5. Last Name*
7. Email Address*
8. Phone Number*
10. Address*
12. City
13. State
14. Zip Code
16. Are you age 18 or over?*

    1. Yes
    2. No
17. What type of assistance are you willing to provide?*

    1. Mowing lawns
    2. Painting
    3. Raking leaves
    4. Snow removal (shoveling or blowing)
    5. Sweeping (patios / driveways / garages)
    6. Trimming shrubs/bushes
    7. Washing outdoor patio furniture
    8. Weeding
19. Agreement*

    I understand that I am responsible for providing my own tools and equipment and/or negotiating with the property owner to use theirs to undertake the work. I authorize the Village to give out my name and phone number to other Village residents interested in requesting my assistance for the services noted.

    1. Agree
    2. Disagree
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field