Volunteer Form

Name

Phone Number

Alternate Contact Number

DOB

Emergency Contact Person and Phone Number

Volunteer

Upload Police report

Age Range

Under 15 15-17 18 and older

Volunteer Activities / Objectives

I Certify I certify that all answers given herein are true and complete to the best of my knowledge. I authorize AutismSoccer to make such inquiries into my background as may be necessary for volunteer work. About my activities as a volunteer I agree to hold confidential all information which I may have access. Disclosure of such information of unauthorized person is prohibited and may result in my dismissal from the volunteer program. I am aware that AutismSoccer does not provide insurance coverage for volunteers if personally injured or if damage occurs to personal property while acting as a volunteer. I further understand that I will not receive pay for volunteering (unless specific arrangements are made) and am not entitled to Workers compensation or health insurance