Volunteer Registration Form
Host name: STRIDE Adaptive Sports
Camp dates: June 24, 2019 - June 28, 2019
Camp location/address: Messa Rink, Union College, 807 Union St. Schenectady, NY

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 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.
If you are under 15, please contact the Camp Host for possible opportunities.

For questions please contact Megan Evans at mevans@stride.org
Volunteer Name *
First Name Last Name
Gender *
Date of Birth *
MM
/
DD
/
YYYY
T-shirt size
Clear selection
E-mail address *
Please ensure you have entered a valid email. The Camp Host will use this address when corresponding with you.
Cell Phone *
Please enter 10 digits
Home Address (Number and Street) *
123 Any Pl.
Home Address (City) *
Wonderful
Home Address (Zip Code) *
24578 (5-digits)
Home Address State/Province *
Virginia
Emergency Contact Name *
Emergency Contact Phone *
Please enter 10 digits
Parent/Guardian Email (if volunteer is under 18 y/o)
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