SUSAN G. KOMEN RACE FOR THE CURE®
April 18, 2009
VOLUNTEER SIGN-UP FORM
Volunteer Name___________________________________________________
Address:_________________________________________________________
Phone #_________________________________________
E-mail address ___________________________________
Area(s) of interest: _________________________________________________
________________________________________________________________
________________________________________________________________
Volunteers are needed in many capacities including: registration, traffic control, water stations, National Sponsor Booths, Merchandise Booth, I Am The Cure and Grounds Patrol on the day of the race. Volunteers will also be needed for Race set up on Friday, April 17, 2009 and for Team Packet pick up on April 15, 16, and 17th.
If you would like to Volunteer, please complete and return this form by email to: madina_ramage@hotmail.com or via fax or mail using the info listed at the bottom of this form.
If you have questions about volunteering, please contact:
Contact Name: Madina Ramage
Contact Phone: Cell: (601) 942-9873; Fax: (601) 932-7539
Contact Address: 1030C N. Flowood Dr. / Flowood, MS 39232
Thanks. This Race is not possible without volunteers!
I wish to volunteer for the Central Mississippi Affiliate of the Susan G. Komen Breast Cancer Foundation, Inc. (the “Komen Affiliate”). I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified and/or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this and in consideration of being allowed to volunteer, I hereby assume full and complete responsibility for any personal injury and/or property damage that I sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless and covenant not to file suit against the Komen Affiliate, the Susan G. Komen Breast Cancer Foundation, Inc. (the “Foundation”) and any of their employees, volunteers, partners, agents, sponsors, board members and successors from any and all loss, liability or claims I may have arising out of my service as a volunteer.
I understand that as a volunteer, I may become privy to confidential information about the Komen Affiliate or the Foundation. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about the Komen Affiliate’s or the Foundation’s internal procedures, business operations, personnel information and the like that is not otherwise publicly disclosed by the Komen Affiliate or the Foundation. I will not use any confidential information in any manner that would be detrimental to the Komen Affiliate or the Foundation, and I will avoid any actions that might impair the reputation of the Komen Affiliate or the Foundation.
Printed name of volunteer:
Volunteer’s Signature:
*Parent’s or Guardian’s Signature:
*(If volunteer is under age 18)
|