2012 Canadian Death Race - Volunteer Registration
FirstName
*
MiddleInitial
LastName
*
YearOfBirth
(YYYY)
City
*
ProvinceState
*
Country
*
HomeTel
*
WorkTel
CellTel
CellMakeandModel
Email
*
Special Skills and Equipment
Quad
Please Select
yes
and willing to bring and use it
4WD
Please Select
yes
and willing to bring and use it on tough terrain
PortableComputer
Please Select
yes
and willing to bring and use it
SearchandRescue
Please Select
yes
EMTNurseMD
Please Select
yes
FirstAid
Please Select
yes
RadioLicense
Please Select
yes
Class3License
Please Select
yes
OtherSkillsEquipment
Veteran
Please Select
yes
have you volunteered with us before
Preferred Shifts
select yes for all those you are willing to do
PreRace
Please Select
yes
ie days/weeks prior to race
Friday
Please Select
yes
Saturday
Please Select
yes
Sunday
Please Select
yes
Monday
Please Select
yes
MaxShiftLength
Please Select
4-6 hours
6-12 hours
Longer
NightShift
Please Select
Want night shift
Willing to do night shift
Do not want night shift
Preferred Locations
select yes for all those you are willing to do
Town
Please Select
yes
Highway
Please Select
yes
Mountain
Please Select
yes
ShortHike
Please Select
yes
LongHike
Please Select
yes
OverNightCamp
Please Select
yes
Preferred Tasks
FirstChoiceCrew
Please Select
Administration
Aid Station
Announcing
Communications
Course Set Up
Kids Race
Marshal
Opening Ceremonies
Registration
Rapid Response Team
Sweeper
Timing
Videography
SecondChoiceCrew
Please Select
Administration
Aid Station
Announcing
Communications
Course Set Up
Kids Race
Marshal
Opening Ceremonies
Registration
Rapid Response Team
Sweeper
Timing
Videography
ThirdChoiceCrew
Please Select
Administration
Aid Station
Announcing
Communications
Course Set Up
Kids Race
Marshal
Opening Ceremonies
Registration
Rapid Response Team
Sweeper
Timing
Videography
Group
Please Select
Alliance
AWN - Asenewuchi Winewak Nation
GPFS
Rangers
Sorority
WATC (Military)
1 CMBG (Military)
1 SVC BN (Military)
2 SVC BN (Military)
2 PPCLI (Military)
3 PPCLI (Military)
Recce (Military)
please select if you are a member of one of these groups
Coworker
enter who you would like to work with
Comments
Token
*
Please Select
S
M
L
XL
Select a T-Shirt as a token of our appreciation.
Parent or Guardian (if volunteer is under the age of 18)
First Name
Last Name
Consent
*
By selecting this button, I, as a volunteer (or parent/guardian if the volunteer is under the age of 18), in consideration for participating in the race, release the Canadian Death Race, or anyone or any entity connected with the race from any liability should I suffer injury, death or property damage, resulting from my participation in the race from any cause whatsoever, including negligence.
Submit Form
Should be Empty: