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VOLUNTEER REGISTRATION

BACKGROUND CHECKS

MEDIA RIGHTS RELEASE

IF UNDER 18

NAME *
NAME
GENDER *
I HAVE SUBMITTED TO A CORNERSTONE BACKGROUND CHECK AFTER FEBRUARY, 2018 *
ADDRESS *
ADDRESS
PHONE *
PHONE
PARENT PHONE (IF UNDER 18)
PARENT PHONE (IF UNDER 18)
EMERGENCY CONTACT PHONE *
EMERGENCY CONTACT PHONE
FORMER SPECIAL NEEDS SKILLS/TRAINING (CHECK ALL THAT APPLY)
I HAVE VOLUNTEERED AT A NIGHT TO SHINE EVENT IN THE PAST *
VOLUNTEER ROLE REQUESTED (CHOOSE ONLY 3) *