CLC YMCA VOLUNTEER INTEREST FORM Question Title * 1. About You Question Title * 2. Are you a CLC YMCA member? Yes No Question Title * 3. Date of Birth (month/day/year) Question Title * 4. Are you 18 years of age or older? Yes No Question Title * 5. Mailing Address Question Title * 6. Phone Number Question Title * 7. Email Address Question Title * 8. Are you interested in volunteering as an individual or a group? Individual Group Question Title * 9. First Name of Emergency Contact Question Title * 10. Last Name of Emergency Contact Question Title * 11. Phone Number of Emergency Contact Question Title * 12. Have you volunteered, or previously worked for the CLC YMCA before? Yes, I have volunteered for the CLC YMCA! Yes, I am a former CLC YMCA employee! No, I have neither volunteered at or worked for the CLC YMCA. Question Title * 13. I want to volunteer because I'm interested in (check all that apply): Gaining Experience/Networking Giving Back to the Community Earning Service Hours for Education Question Title * 14. I'm interested in volunteering for the following CLC YMCA areas (check all that apply): Adult Sports Programs Youth Sports Programs FARMS at the Y (Food Education) Thrive — After-School Youth/Teen Programs Fill the Y Bus (Community Outreach) Special Events Tennis Pickleball Y-Arts Summer Camps Question Title * 15. I'm interested in (check all that apply): Experience/Networking Giving Back to the Community Community Service Hours for School Credit (share school name in comment field) Court-Appointed Community Service To Share a Passion/Hobby Employer Referral (share employer name in comment field) Other Question Title * 16. Are there any special skills that you or your group may be able to provide? Question Title * 17. Are there any limitations we should be aware of during your volunteer experience? Question Title * 18. Do you have any food or environmental allergies we should be aware of during your volunteering experience? Question Title * 19. Are there any days of the week or specific dates you are interested in volunteering? Question Title * 20. How did you hear about volunteer opportunities with the CLC YMCA? CLC YMCA Visit Internet Search Facebook Instagram CLC YMCA Newsletter Volunteered Previously at the CLC YMCA Word of Mouth Other (please specify) Question Title * 21. I authorize the CLC YMCA to use my photo or likeness in promotional or informational materials, which may be distributed to the general public in print and digital media in order to highlight volunteer achievements. Yes No Done