Volunteer Form

KM Youth Fishing Team Volunteer Form
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Fishing Experience*

BeginnerExperiencedAccomplished
Level of Volunteer Interest

Local Fishing CoachAdvanced Bass CoachAssistant CoachClassroom InstructionAdministrative HelpMedia/AdvertisingFundraisingOther
Emergency Contact Name #1*

First NameLast Name
Emergency Phone Contact #1*
Please enter a valid phone number.
Emergency Contact #1 Relationship to you*
Emergency Contact Name #2*

First NameLast Name
Emergency Phone Contact #2*
Please enter a valid phone number.
Emergency Contact #2 Relationship to you*

Medical Information*

	None	Specify
Allergies
Medical Condition

I grant the Kasson Mantorville Youth Fishing Team the right to take photographs of me, my property and my minor child. I agree that they may use such photographs, with or without my name, for any lawful purpose including publicity, advertising, and web content.*

YesNo
By signing this form you acknowledge the following:
- The Kasson Mantorville Youth Fishing Team is not responsible for any injuries that may occur and hereby assume any risks involved with participating in this activity. In the event I become ill or injured while participating in any team activity, I hereby give my consent to team officials or their designee, its members and/or officers to authorize the administration of any emergency medical treatment deemed necessary.
- I have reviewed AND understand the chemical policy and handbook for the Kasson Mantorville Youth Fishing Team.
- I acknowledge that a criminal background check will be done on my behalf through the MN Bureau of Criminal Apprehension at no cost to me
Signature*

Clear
Name*
Date*

MonthDayYear
Date
Should be Empty: