Dental Kit Initiative Volunteer Registration and Release Form
A release form is needed from each volunteer. All information must be completed in order to participate in a volunteer project. Information will not be shared outside of the United Way of Lane County, your project location or your organization.
Email address *
First and Last Name *
Your answer
Are you under the age of 18 or volunteering with someone under the age of 18? *
If yes, what is their name?
Your answer
I give United Way of Lane County permission to contact me via email with important updates, event invitations and volunteer opportunities. (You may opt out at any time) *
Phone Number *
Your answer
Mailing Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Are you volunteering with a company or organization? If yes, which one? *
Your answer
What days will you attend? *
Required
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