VOLUNTEER Registration Form Kid's Day Out March 17th, 2012

Hosted by: IMPACT Autism @ UF
Date / Time: Saturday March 17th 2012, 12:30-4 p.m.
Location: Westside Park, Gainesville (1001 Northwest 34th Street Gainesville, FL 32605)
*The kids will arrive at 1 p.m., but at 12:30 pm we will be going over procedure for the event before the kids get to the park. We recommend you be there at 12:30 so you can receive information!


IMPACT Autism hosts Kid's Day Out events open to all children in the Gainesville Community. 2 volunteers are matched to 1 child and spend the day interacting with them in a fun and safe atmosphere. IMPACT will provide training to those volunteers who request it!

Directions: Please complete the following form to volunteer at this event to help us provide a good experience for you and the children.

***Note: This form is the FINAL step to be a volunteer. Before you begin, have you:
1. Paid your club dues?
2. Completed the HIPAA compliance and confidentiality statement?
http://privacy.health.ufl.edu/training/hipaaPrivacy/instructions.shtml
3.Completed your background check with Alachua County Sherriff's Office?
(for more details email us at impact.autism@gmail.com)


***Please know that if you commit to volunteering for an event we are counting on you to be there that day. Please only sign up if you are sure you can be there. If something comes up and you are unable to attend, PLEASE notify us so that we can make arrangements!

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question