Dedicated to Supporting Families and Our Local Community
Volunteer Registration Form
First Name: (required)
Last Name: (required)
Parent/Guardian name (if under 18 yrs.):
Home Phone: Cell Phone: Office Phone:
Your Email: (required)
Preferred Contact Method: home phone cell email
City: State: Zip:
Emergency Contact Information
In the event of an emergency, who would you like contacted:
Phone Number: Alternate Phone Number:
Select a T-Shirt Size
Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult 2XL
Administrative Assistant This individual will assist in the check-in process and other administrative duties during the camp.
Spotter Spotter: This individual will run alongside a child as they are learning to ride a bike. They will provide physical support and encouragement.
Please determine your highest level of fitness:
I can jog at a moderate pace for one hour with short breaks I can walk fast for one hour with short breaks I can walk steadily for one hour with short breaks I cannot walk at a steady pace for one hour with short breaks
Please indicate the times when you will be available to volunteer. Please note that we ask you to commit to working the entire week of the camp for the session(s) you select. Campers bond with their volunteers and rely on the same person to be there each day to help them learn to ride. It is important that you arrive 15 minutes prior to your session start time for a daily briefing.
Session 1 8:30am-9:45am Session 2 10:05am-11:20am Session 3 11:40 am-12:55pm Session 4 2:00pm- 3:15pm Session 5 3:55pm-4:50pm
What is your profession?
Do you have experience working with individuals with disabilities? ---YesNo
If yes, please explain:
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