2019 CASA Heritage Run Volunteer Form
Thank you for help. We will contact you once you submit this form and work with you to assign you a task during the time you are available. All information is confidential and will not be shared with any third party. If you are under 18 years of age an adult (18 year of age and older) will need to volunteer with you.

If you have any questions please contact Leslie Erickson at or lerickson@winnebagocountycasa.org, or at 815-978-2322 .
Visit the 2019 Heritage Run Website: http: //winnebagocountycasa.org/news-events/heritage-run.html

Email address *
What is your full name:
Your answer
What is your date of birth:
What is you phone number:
Your answer
Address: street, city, zip and state.
Your answer
Emergency contact:
Your answer
What would you like to volunteer for? Please check all that apply.
A copy of your responses will be emailed to the address you provided.
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