Volunteer

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Age (Optional)

Race/Ethnicity (Optional)

Other

Gender Identification (Optional)

Other

Programs *

Please select 1 or more of the programs that you would be interested in volunteering for

Photo and Video Release *

I acknowledge that any photos and videos taken during Tater Tots Pediatric Therapy's community programs can and will be used for informational and advertising materials. The use of photos and videos may include, but is not limited to, social media posts, posts on the organization's website, digital advertisements, news stories, and paper advertisements.

Background Check *

I give my consent for Tater Tots Pediatric Therapy to perform a background check using the information provided within this registration before beginning my participation as a volunteer for their organization.

Signature

You agree your E-Signature is the legal equivalent of your manual signature on this registration form, as if actually signed by you in writing.

Volunteer Today