San Jose Kicks For Kids Volunteer Registration Form (2018-2019)
Thank you so much for your interest in volunteering to be a part of San Jose Kicks for Kids! This event would not be possible without the help of our amazing volunteers. Please read the following information and complete the registration form below*. Please note, if the volunteer is under 18, this form must be completed by a parent or guardian.

Mark your calendars with our Spring 2019 Season dates:
March 3, March 10, March 17, March 24, March 31

All events take place at Gunderson High School in San Jose, California. You will receive more information via email during the week leading up to each event.

*PLEASE NOTE: If you registered for our Fall 2018 Season, you WILL NOT need to complete another registration form to participate in the Spring 2019 Season. Your registration from Fall 2018 is effective through the last session of the Spring 2019 Season. If you are unsure about your registration status, please email us at sanjosekfk@gmail.com and we would be happy to confirm it for you!

**IMPORTANT: All Kicks for Kids communication is conducted via email. The organization will send all details and updates (including any potential cancellations) to the email address that you list below, so please be sure to check the listed email address frequently.

If you have any questions, please email us at sanjosekfk@gmail.com.

Email address *
Volunteer's First Name: *
Your answer
Volunteer's Last Name: *
Your answer
Volunteer's Age: *
Please note: If the volunteer is under 18, this form must be filled out by a Parent or Guardian.
Your answer
Student ID#: *
If you are not a high school student, please enter your driver's license or California State ID number.
Your answer
What school do you go to? *
What year in high school are you? *
Adult T-Shirt Size: *
While we will do our very best to accommodate your size preference, please understand that the sizes are on a first come, first serve basis, and our supply is limited. Only one shirt will be given per volunteer. If the volunteer has attended Kicks for Kids before, we ask that you please bring your old shirt so that we can provide as many people with shirts as possible.
Will you allow your (or your child's) photo and/or video to be taken in collaboration with Kicks for Kids? *
By selecting yes, you understand that the images may be for promotional purposes and may be used on platforms such as, but not limited to, print publications, online publications, presentations, websites, and social media. You also understand that no royalty, fee, or other compensation shall be made payable to you by reason of such use. Pictures and/or videos will generally be made available on our Facebook page if you would like to view them.
How did you hear about us?
Your answer
Additional Comments/Questions:
Your answer
Acknowledgement of Duty To Report Child Abuse: California law requires certain persons to report known or suspected child abuse or neglect. These individuals are known under the law as “mandated reporters.” Because of the nature of your job responsibilities, you are a mandated reporter. California law requires certain persons to report known or suspected child abuse or neglect. These individuals are known under the law as “mandated reporters.” Because of the nature of your job responsibilities, you are a mandated reporter. A mandated reporter, who in his or her professional capacity, or within the scope of his or her employment, has knowledge of or observes a person under the age of 18 years whom he or she knows or reasonably suspects has been the victim of child abuse or neglect must report the suspected incident. The reporter must contact a designated agency immediately or as soon as practically possible by telephone, and shall prepare and send a written report within 36 hours of receiving the information concerning the incident ABUSE THAT MUST BE REPORTED: • Physical injury inflicted by other than accidental means on a child. • Sexual abuse meaning sexual assault or sexual exploitation of a child. • Neglect meaning the negligent treatment, lack of treatment, or the maltreatment of a child by a person responsible for the child’s welfare under circumstances indicating harm or threatened harm to the child’s health or welfare. • Willful harming or injuring or endangering a child meaning a situation in which any person inflicts, or willfully causes or permits a child to suffer unjustifiable physical pain or mental suffering, or causes or permits a child be placed in a situation in which the child or child’s health is endangered. • Unlawful corporal punishment or injury willfully inflicted upon a child and resulting in a traumatic condition. WHERE TO CALL IN AND SEND THE WRITTEN ABUSE REPORT: Reports of suspected child abuse or neglect must be made to each of the following: • Immediately via telephone report to the Department of Children and Family Services Child Protection Hotline at (800) 540-4000. • Within 36 hours via written report to the Department of Children and Family Services on Form SS8572 (Suspected Child Abuse Report). The Child Protection Hotline will explain how to get the form. A mandated reporter who fails to make a required report is guilty of a misdemeanor punishable by up to six months in jail, a fine of $1000, or both. *
By electronically signing my name below, I understand and acknowledge my responsibility to report known or suspected child abuse in compliance with Penal Code requirements.
Your answer
Confirmation Signature (or Parent/Guardian's Signature if Volunteer is under 18) *
By electronically signing below, I acknowledge that I have read this form in its entirety and understand the expectations of a volunteer. I also agree to comply with Kicks for Kids staff in the provision of volunteer services and to act reasonably and professionally while volunteering. I also agree to complete the Liability Release and submit it to Kicks for Kids prior to volunteering with the organization. Please type your full name below (i.e. "John James Doe").
Your answer
A copy of your responses will be emailed to the address you provided.
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