CCC Child Care: Volunteer Form
As a community, we need as many medical professionals as possible working to fight the COVID-19 outbreak. In light of school closures across Sacramento, many hospital staff (nurses, technicians, medical professionals, etc.) are forced to choose between going to work and taking care of their children.
Sacramento needs your help to combat the COVID-19 outbreak. Please sign up below if you are willing and able to be a volunteer babysitter!
If you have any questions, concerns, or suggestions, feel free to contact us at
covidcc.sacramento@gmail.com
or visit our website
covidcommunitycare.org
* Required
Full Name:
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Your answer
Phone number:
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Your answer
Email:
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Your answer
Location: (Example: West Sacramento)
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Your answer
Availability: (Example: Mondays 6am-9pm, Saturday and Sunday 9am-4pm etc.)
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Your answer
Age:
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Your answer
Do you have a valid driver's license and access to a car?
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Yes, I have a valid driver's license, I am able to drive others, and I have access to a car.
No, I do not have all of these capabilities.
Current school/occupation:
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Your answer
Prior childcare/babysitting experience:
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Your answer
Are you willing to provide other services to medical workers including, but not limited to errands/ grocery runs?
Yes
No
Clear selection
Do you speak any languages besides English?
Your answer
Age range of children you are comfortable working with: (Example: 4-13)
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Your answer
Can you babysit at your house?
Your answer
Have you been vaccinated? If yes, how many doses have you received?
Your answer
Have you ever been arrested, charged, or convicted of a crime anywhere in the world? If yes, please provide the date and circumstances.
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Your answer
Have you ever been investigated by a child protection services agency for concerns of child neglect or abuse? If yes, please explain.
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Your answer
How did you hear about us?
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Your answer
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