LJC Volunteer Registration Form

Lansing Juneteenth Celebration Volunteer Registration

This form is for volunteers 18 and over. Volunteers under the age of 18 may participate under the direction of organizations, such as scouts, student groups, church groups, etc. Adult coordinators of groups with minor volunteers should send an email to info@lansingjuneteenthcelebration.org. All volunteers 18 and over will receive a background check. The information from this check will not be used for any purpose other than assessing your suitability for volunteering.
Volunteer Full Name*

First NameMiddle NameLast NameSuffix
Primary Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
Volunteer Positions and Availability

Click all that apply
Volunteer Positions (In which areas are you interested in volunteering? Select all that apply)

Wherever needed!Pre-Festival Set-Up (assist vendors, etc.)Clean-up (assist with grounds, trash disposal)Post festival break-downParade AssistantStage Decoration (Fri. Only)Greeter (Kickoff Date)Children's Arts, Crafts, GamesParking AssistantFlyer Distribution (Dates to be provided)
Sunday, June 4

5:00pm Signage Distribution (Route to St. Joseph Park)5:00pm Flyer Distribution (WestsideNeighborhood, parade route)
Availability - Friday, June 14 (Pre-Festival Set-Up)

1:00pm to 4:00pm4:00pm to 8:00pm
Availability - Saturday, June 15 (Parade, Vendor Assistance, Information, Grounds, Stage, Children's Games & Crafts, Clean-up)

9:00am to 12:00pm12:00pm to 3:00pm3:00pm to 6:00pm6:00pm to 9:00pm
Other Availability or Positions
Please Describe
Emergency Contact Information
Primary Emergency contact name*

First NameLast Name
Relationship to volunteer
Primary Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Secondary Emergency Contact name

First NameLast Name
Relationship to volunteer
Primary Phone Number

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Background Information
Race/Ethnicity (Check One)

American Indian or Alaska NativeAsianBlack or African AmericanHispanicNative Hawaiian or Other Pacific IslanderWhiteTwo or More RacesOther
Gender

FemaleMale
Date of Birth*

MonthDayYear
By submitting this form, I hereby authorize the P.E.E.R.S board to conduct a security background check on me. I understand that this security check will cover information including, but not limited to, criminal history, and sex offender’s registry checks. I hereby release the P.E.E.R.S and its agents and assigns, as well as the Company performing the background checks, from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organizations guidelines. I certify that the statements made by me on this form are true, complete and correct to the best of my knowledge, and beliefs and are made in good faith. I understand that any false statements herein could void my considerations as a volunteer for the Juneteenth Celebration.
Should be Empty:

Lansing Juneteenth Celebration Volunteer Registration

Volunteer Positions and Availability

Emergency Contact Information

Background Information