Volunteer
Coastal Medix offers volunteer opportunities for EMT, paramedic, nursing, and healthcare students looking to gain real-world event medical experience. Complete this form to get started.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
School or Program Name
*
Level of Education
*
Please Select
EMT Student
EMT
Paramedic Student
Paramedic
Nursing Student
RN
Other
If other, please let us know what field you're in
*
Do you currently hold a CPR card?
*
YES
NO
Are you looking for specific school-required hours?
*
YES
NO
Just to learn and have fun
What days/times are you typically available?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What types of events interest you most?
*
Concerts
Festivals
Sports
Community Events
No Preference
Do you have any comments or requests for the team?
Is there a specific event you're looking to volunteer at?
Please check if you'd like to be on our upcoming volunteer contact list.
Yes please add me to the announcement list
No thank you
EMERGENCY CONTACT
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
*
Waiver & Acknowledgments
Volunteer Observer Acknowledgment
I understand that this is a volunteer, unpaid observational and educational opportunity intended to provide exposure to event medicine operations and is not a guarantee of employment with Coastal Medix. I understand that volunteers are supplemental to event staffing and are not included as part of minimum required staffing for any event. I also understand that participation may be limited based on my certification level, licensure, experience, venue requirements, and operational needs. I agree to follow all directions and safety instructions provided by Coastal Medix personnel at all times.
*
I understand
Confidentiality / HIPAA Acknowledgment
I understand that during participation with Coastal Medix, I may observe confidential or protected information, including patient information. I agree to maintain patient confidentiality and will not disclose, photograph, record, post online, or otherwise share protected or sensitive information learned during participation. I also agree to follow all Coastal Medix confidentiality and privacy policies at all times.
*
I Agree
Photo / Video Release
I give permission for Coastal Medix to take and use photographs and/or video of me during volunteer observer activities for marketing, training, educational, and promotional purposes. I understand these images may be used on social media, websites, printed materials, and other company media platforms. I understand that selecting “No” will not affect my ability to participate in the volunteer observer program.
*
Yes, I give permission
No, I do not give permission
Assumption of Risk & Liability Waiver
I understand that participation in event and medical environments may involve inherent risks, including exposure to large crowds, weather conditions, uneven terrain, emergency situations, illness, physical activity, and other event-related hazards. I voluntarily assume all risks associated with participation in Coastal Medix volunteer observer activities. I agree to follow all safety instructions and immediately report any unsafe conditions, injuries, or concerns to Coastal Medix personnel. To the fullest extent permitted by California law, I release and hold harmless Coastal Medix, its staff, affiliates, venue partners, and representatives from liability, claims, or demands arising from my voluntary participation, except in cases of gross negligence or willful misconduct.I understand this opportunity is unpaid, educational in nature, and does not create an employment relationship.
*
I Acknowledge & Agree
By signing below, I acknowledge that I have read, understood, and agree to the above acknowledgments, policies, and waiver terms related to participation in the Coastal Medix Volunteer Observer Program. I understand that this is a voluntary, unpaid, educational experience and that I may ask questions regarding this agreement prior to participation.
*
Continue
Continue
Should be Empty: