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Ozark - Volunteer

 

Volunteer Application

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Question - Required - Date




2. Your information:

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Name:

 

 

   

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City/State/ZIP:

 

    

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Date of Birth:

 

 

 


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Question - Required - Please indicate if you have more than one year of experience in the following areas: (You may select multiple areas)

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Question - Not Required - How often would you like to volunteer?



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Question - Not Required - I'm interested in a:


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  Komen Volunteer Release
Emergency Contact:
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I wish to volunteer with the Susan G. KomenŽ Ozark . 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 or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this, I hereby assume full and complete responsibility for any personal injury and/or property damage that I may sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless & covenant not to file suit against the Komen Affiliate, Susan G. Komen®, Inc. and 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 Susan G. Komen®. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about the Komen Affiliate’s or Susan G. Komen®’s internal procedures, business operations, personnel information and the like that is not otherwise publicly disclosed by the Komen Affiliate or Susan G. Komen®. I will not use any confidential information in any manner that would be detrimental to the Komen Affiliate or Susan G. Komen®, and I will avoid any actions that might impair the reputation of the Komen Affiliate or Susan G. Komen®.

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