Walk for Wellness House Volunteer Application Form
Please complete this application form if you are interested in becoming a Wellness House volunteer and volunteering at our Walk For Wellness House event. Once you complete the form, click the submit button at the bottom.

Name and address


Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.


Emergency Contact


Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.


Assignment Preference


How did you hear about this volunteer opportunity?


Agreement

I recognize and hereby expressly assume all risks and am participating in this event upon the express agreement and understanding that I am hereby waiving and releasing Wellness House, its agents and representatives, from any and all claims which may accrue to me, my heirs, my guardians, administrators, executors, or assignees, including my attorney's fees and court costs (collectively "claims") arising out of, or in connection with, my participation in the "Walk for Wellness House," or any illness resulting therefrom.

I also grant permission to Wellness House and its authorized agents to use my name and photograph, videotapes, and any other records of my participation in this event.