REACH Bingo Volunteer Form
This form is required to volunteer at Bingo with REACH. Only the person who is volunteering (or their guardian) should complete this form.
Name of person completing this form
*
Prefix
First Name
Last Name
Suffix
I am 18 or older
*
Yes
No
Are you completing this form for someone between the ages of 14 & 17? Volunteers ages 14 to 17 must be accompanied by a parent or caregiver at all times. All volunteers must have a have a valid form of identification on them at all times.
*
Yes
No
If applicable, what is the name of person under the age of 18
First Name
Last Name
How are you related to the volunteer?
Self, parent, grandparent, etc.
Are you volunteering as part of a company event/initiative?
*
Yes
No
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I require documentation regarding my volunteer service
Yes
No
Back
Next
Service Letter and State Waiver
What date to you need your letter by?
-
Month
-
Day
Year
Please note that we ask for 48 hours after your last volunteer experience. Letters will be emailed to the email address you provided above.
If your service requires documentation, who should the letter be addressed to?
The Honorable Court, Your command, Your Company, etc.
We are required by the state of Virginia to ensure all volunteers backgrounds meets the following criteria: No person shall participate in the management or operation of any charitable game if he has ever been convicted of any felony or if he has been convicted of any misdemeanor involving fraud, theft, or financial crimes within the preceding five years. No person shall participate in the conduct of any charitable game if, within the preceding 10 years, he has been convicted of any felony or if, within the preceding five years he has been convicted of any misdemeanor involving fraud, theft, or financial crimes. In addition, no person shall participate in the management, operation, or conduct of any charitable game if that person, within the preceding five years, has participated in the management, operation, or conduct of any charitable game which was found by the Department or a court of competent jurisdiction to have been operated in violation of state law, local ordinance, or Department regulation.
*
I have NOT been convicted of any felony or have been convicted of any misdemeanor involving fraud, theft, or financial crimes within the preceding five years.
I have NOT been convicted of any felony within the preceding 10 years.
I have not participated in the management, operation, or conduct of any charitable game which was found by the Department or a court of competent jurisdiction to have been operated in violation of state law, local ordinance, or Department Regulation.
I understand that my name and information will be shared with the state and any falsification of information will be my sole responsibility, along with any reprocussions due to falsifying information to the State of VA.
Signature
*
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Next
Photo Authorization, Release & Consent
Can we use your name?
Yes, you can use my complete name
Yes, but first name only
You can use my picture, but not my name
Please check each box to confirm you have read the waiver.
I authorize and grant REACH and it's partners to take/use my photos/videos regarding my experiences with them.
I grant REACH and it's partners to use my photos on Facebook, Twitter, Instagram, and other social media platforms to highlight their mission or promote upcoming opportunities.
I allow REACH and it's partners to edit, alter, copy, or distribute the photos/videos for social media advertising, programming and marketing.
I agree that the photos belong to REACH and it's partners.
I understand that I will not receive any monetary compensation.
Signature
Submit
Should be Empty: