BREATHE Volunteer Registration
Please complete the information below to register as a Breathe Volunteer.
Make sure this is one you check!
Name of organization.
Ex.: Church, High School, Service Club, etc.
What size t-shirt do you prefer?
All t-shirts are adult sizes.
Grade for current School Year
I am an adult
I am younger than 8th grade
How did you learn about BREATHE?
Current Mailing Address
Include street, city and zip
Name of Emergency Contact
Phone Number of Emergency Contact
Diocesan Safe Environment Regulations for Adults
In accordance with diocesan policy all adults (18 yrs and older) assisting with children must complete a background screening and attend the VIRTUS training.
I am not 18 yrs or older
I have completed the background screening for the Diocese of Richmond.(updated every 4 years)
I am Virtus certified
Please send me information regarding the above requirements.
In what capacity would you like to serve at BREATHE?
Buddy (friend for the night)
Certified Medical Professional
Anything else you want to tell us?
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Terms of Service