Volunteer Information Form
Thank you for sharing your time and talents with Wellspring!
First Name
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Last Name
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Phone Number
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Best time to contact
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Email
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Street Address
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City
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State
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Zip Code
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Birthday (month/day)
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I am interested in earning the following volunteer rewards (check all that apply)
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Emergency Contact Name
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Emergency Contact Phone Number
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Emergency Contact Street Address
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Emergency Contact City, State, Zip
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Please indicate which volunteer activities that interest you or let us know how you feel you can help (check all that apply)
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We would like you to be aware that Wellspring/Cori Terry & Dancers does not have insurance for volunteers. Please read the following and provide your electronic signature below
Hold Harmless Agreement
As a volunteer for Wellspring/Cori Terry & Dancers, the undersigned agrees to be responsible for any bodily injury, sickness, or property loss/damage sustained while serving as a volunteer. Further, the undersigned agrees to hold harmless the entity known as Wellspring/Cori Terry & Dancers, its employees, agents, directors, other volunteers, and participants for any bodily injury, sickness, or property loss/damage sustained while serving as a volunteer.
Volunteer Electronic Signature (or Legal Guardian if under age of 18)
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