Saturday May 18th, 2019

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We are excited to have you be a part of our team!

We are excited to have you be a part of our team!

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* 1. Please provide your contact information.

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* 2. What is your gender?

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* 3. When is your birthday?

Date

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* 6. If you are a part of a Service Club, Corporation, or Knights of Columbus please identify which specific group you are affiliated with.

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* 7. If there is any additional information you would like to provide please state below.

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* 8. By checking the box below you are agreeing to abide by all NEDSRA policies and guidelines for this program. I understand this is a commitment and not a contract, and that NEDSRA provides liability coverage, but not Workers’ Compensation or medical coverage for volunteers.

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