Volunteer Registration Form
Thank you for volunteering for the iCan Bike program presented by the Down Syndrome Advocacy Foundation and the Center for Community Inclusion at LIU Post. iCan Shine is a non-profit organization that teaches individuals with disabilities to ride a conventional two-wheel bicycle through its iCan Bike program. We are pleased to bring this program to our community, and would like to thank you in advance for your contribution.

Host name: Susan Antonio & Jenny Andersson
Camp dates: June 25, 2018 - June 29, 2018
Camp location/address: LIU Post 720 Northern Blvd-Pratt Recreation Center., Brookville, N.Y. 11548

We are pleased to offer this bike program to people with disabilities and look forward to having you play an important part in helping our special riders learn to ride a two-wheel bicycle independently

***NO PRIOR EXPERIENCE WORKING WITH PEOPLE WITH DISABILITIES IS NECESSARY***

AGE REQUIREMENT: Volunteers must be at least 15 years old

Volunteer Name *
Your answer
Gender *
Date of Birth *
MM
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DD
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YYYY
T-shirt size
E-mail address *
Your answer
Cell Phone *
Please enter 10 digits
Your answer
Home Address (Number and Street) *
123 Any Pl.
Your answer
Home Address (City) *
Wonderful
Your answer
Home Address State/Province *
Virginia
Home Address (Zip Code) *
24578 (5-digits)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Please enter 10 digits
Your answer
Comments
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