Emergency Assistance
Non-Emergency Assistance
Completed Projects

Offer to provide a materials/supplies for a non-emergency Lions project/mission.

If you have materials or supplies that you would like to provide, please complete the form below. Your offer will be entered into the Lions Clubs International database. Please read carefully the "Waiver of Liability" at the end of the form.
*Required
*My First Name:  
*My Last Name:  
My Phone Number:  
(Phone numbers will not appear on the Lions Web site. This is a secure site.
Only Lions Headquarters staff will receive phone numbers.)
*My E-mail:  
My Lions club:  
My District Number:  
*My Language Preference:  
My Second Language:  

*I can provide:

Medical equipment (surgical equipment, x-ray machines)
Medical supplies (usable supplies such as bandages, plasma)
Survival supplies (potable water, food, tents, blankets, clothing)
Construction supplies
Electrical supplies
Vehicles - trucks or automobiles
Cellular telephones
Computers
Office equipment
Cooking supplies and food
Furniture
Appliances
Bedding
Household items
Other  

Waiver of Liability & Indemnity Agreement

The undersigned Project Sponsor agrees and understands that participation in the Lions Emergency/Non-Emergency Assistance Database Program is voluntary. As such, the Project Sponsor his/her heir, personal representatives or assigns, hereby release, waive, discharge and covenant not to sue the International Association of Lions Clubs and Lions Clubs International Foundation, their officers, trustees, employees and agents from liability from any claims including the negligence of the International Association of Lions Clubs, its chartered Lions Clubs, Lions Clubs International, their officers, members, employees and agents, resulting in personal injury, accidents, or illnesses (including death) and property loss arising from, but not limited to, participating in the Lions Emergency/Non-Emergency Assistance Database Program.

The undersigned project sponsor also agrees to INDEMNIFY and HOLD the International Association of Lions Clubs and Lions Clubs International Foundation HARMLESS from any and all claims, action, lawsuits, procedures, costs, expenses, damages and liabilities, including attorney's fees brought as a result of Project Sponsor's involvement in the Lions Emergency/Non-Emergency Assistance Database Program.