Night to Shine 2019
Volunteer Registration
Volunteer Information
First Name *
Your answer
Last Name *
Your answer
Age/Date of Birth *
Your answer
Gender *
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Parent Name (if under 18):
Your answer
Parent Phone (if under 18):
Your answer
Emergency Contact during event: *
Your answer
Emergency Contact phone number *
Your answer
Background Checks are required for ALL volunteers over the age of 18. Have you had a background check in the last 12-18 months? *
If you are a volunteer under the age of 18, a permission slip signed by your parent/guardian is required to volunteer. This form is on the St John/Night to Shine page. Confirm that you understand this and will be having a parent/guardian sign this.
Former Special Needs Skills/Training (please check all that apply). (Not necessary to volunteer, but allows us to make use of your skills.
If Healthcare professional, please provide the field
Your answer
If selected Other, please explain
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I have volunteered for Night to Shine before *
Click Next to select which volunteer roles that you like to participate in
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