Dental Kits Initiative Volunteer Registration and Release Form

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A release form is needed from each volunteer. All information must be completed in order to participate in a volunteer project. Information will not be shared outside of the United Way of Lane County, your project location or your organization.

Email *

First and Last Name *

Are you under the age of 18 or volunteering with someone under the age of 18? *

Yes

If yes, what is their name?

I give United Way of Lane County permission to contact me via email with important updates, event invitations and volunteer opportunities. (You may opt out at any time) *

Yes

Phone Number *

Mailing Address *

Emergency Contact Name *

Emergency Contact Phone Number *

Are you volunteering with a company or organization? If yes, which one?

What days will you attend? *

February 26: JP Morgan Chase

Required

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