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Susan G. Komen
   
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National Spotlight

Financial Resources — Did you know that there are many financial resources that can help people living with breast cancer? Find out more

Rally for the Cure — Golf, tennis, dinner events and so much more...

Go Passionately Pink to help save lives! — Just wear pink, have fun and raise money to fight breast cancer. Be inspired by the multitude of ideas right here, or think of your own. There are so many creative ways to have fun and fight breast cancer.

Colorado South - 2016 Volunteer Form

 

Volunteer Application

*1.
Question - Required - Date




 

Your Information

2. Questionaire

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Name:

 

 

   

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City/State/ZIP:

 

    

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Date of Birth:

 

 


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*4.
Question - Required - I prefer to be contacted via:

 

Emergency Contact Information:

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*9.
Question - Required - How often would you like to volunteer?



10.
Question - Not Required - When are you available? (Select all that apply)

 

Volunteer Opportunities (Please select all that interest you.)

11.
Question - Not Required - Administration (Select all that apply.)

12.
Question - Not Required - Special Events (Select all that apply.)

13.
Question - Not Required - Please indicate if you have experience in the following areas: (Select all that apply.)

 

Volunteer Release

I wish to volunteer for Susan G. KomenŽ Colorado South . 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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