Winter Track Tune Up Camp Volunteer Application

Please print this form with your and guardians original signature and submit to Allison@achancetorun.com

Email address *

A Chance to Run, Inc. Volunteer Coach Application Form

Please submit your online responses below

Please Check Camp Session *

Week 1 Benderson Park December 26-28th, 2018- 9 am to 11 am.

Week 2 Celery Fields January 2-4th, 2019 - 9 am to 11 am.

Required

Volunteer First Name *

Your answer

Volunteer Last Name *

Your answer

Nick Name

Your answer

Age *

Your answer

Current Grade *

Your answer

Participant's Mailing Address:

Your answer

Volunteer Phone Number: *

Your answer

Parent/Guardian Name: *

Your answer

Parent/Guardian Phone Number: *

Your answer

Alternative Contact (for emergency if you cannot be contacted): *

Your answer

Alternative Contact Relationship: *

Your answer

Alternative Contact Phone Number: *

Your answer

Please describe any first aid training and/or special qualifications. *

Your answer

Have you ever participated in a running sport before? *

Your answer

Please describe any medical issues, allergies or special requirements: *

Your answer

I understand that I am a volunteer for A Chance to Run, Inc. Winter Tune Up Camp under the direction of John Stevenson. This is a non-paid position however I may elect to receive high school community service credit. I will report on time and maintain a professional appearance in uniform. I understand that I am to follow the directions of the adult camp sponsor; adhere to all camp rules and watch out for the safety of the participants to the best of my ability. Should I not be able to perform the above duties, I may be asked not to return nor receive any community service credit. *

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Volunteer Signature: *

Your answer

I give my permission for the above participant to volunteer and take part in A Chance to Run, Inc. Winter Tune Up Track Camp. This volunteer/participant, to the best of my knowledge is in good physical condition and has no know conditions that may cause a health risk to themselves or another participant. I understand that Track, running and other outdoor activities have an inherent risk factor, and that all appropriate precautions will be taken for the participant. I give permission for A Chance to Run, Inc. and it's volunteers and/or hospital staff to administer proper medical assistance to the above named participant. I agree to release and hold harmless A Chance to Run, it's volunteers and benefactors from liability for all claims, resulting in any way from my participation in this Track Camp. I understand there is no affiliation with Sarasota County School System. *

YYYY

Parent Guardian Signature: *

Your answer

A copy of your responses will be emailed to the address you provided.

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