Volunteer

You have selected the following jobs

One Stop Registration & Pick Up
   Saturday, May 4, 2013 (01:00 PM - 04:15 PM)

* Required fields

* First Name:
* Last Name:
* Address:
* City:
* State:
or * Province:
* Zip/Postal Code:
* Country:
* Gender Female Male
* Date of Birth:  
* Email :
Home Phone:
Work Phone:
Cell Phone:
Special Skills you can contribute:
How did you hear about Race for the Cure?:
Group Affiliation:
*How many years have you been a volunteer for the Komen Detroit Race for the Cure?:
Participating in Race?: Yes No
Breast Cancer Survivor?: Yes No
Comment
(eg: who you'd like to work with,
or, list second volunteer choice):
PLEASE READ AND AGREE TO WAIVER
I wish to volunteer for the Susan G. Komen Detroit Race for the Cure(R). I understand the nature of volunteer activities that I may perform in my capacity as 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 DETROIT RACE FOR THE CURE(R), THE BARBARA ANN KARMANOS CANCER INSTITUTE, SUSAN G. KOMEN FOR THE CURE (KOMEN) AND ANY OF THEIR EMPLOYEES, VOLUNTEERS, PARTNERS, AGENTS, SPONSORS, BOARD MEM BERS A ND 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 Detroit Race for the Cure(R) or Komen. I agree to maintain the confidentiality of any information marked "confidential" as well as any information about the Komen Detroit Race for the Cure(R) or Komen's internal procedures, business operations, existing or prospective donor information, proprietary business information, personnel information and the like that is not otherwise publicly disclosed by the Komen Detroit Race for the Cure(R) or Komen. I will not use any confidential information in any manner that would be detrimental to the Komen Detroit Race for the Cure(R) or Komen, and I will avoid any actions that might impair the reputation of the Komen Detroit Race for the Cure(R) or Komen.
 

 
INFO FOR PARENT/GUARDIAN COMPLETING THIS REGISTRATION
Registration for minors must be completed by a Parent or Legal Guardian. If your age on race day is less than 18 years old, please fill in the Parent/Guardian Contact Information below. Providing such information and continuing this process indicates that this registration was completed by the person listed below.
Parent/Guardian Name:
Contact Phone:
Contact Relationship:
 
*Agree to waiver: I agree I do not agree