Do you have any medical issues that may affect your ability to act or volunteer under certain conditions (i.e. epilepsy etc.)? *
Your answer
Do you take any Medication that may impair your ability to act (i.e. narcotic pain medication) or do you have any emergency medication that you may need to carry on you while volunteering (i.e. insulin, epi-pen)? *
Your answer
Do you have any allergies we should be aware of? *
Your answer
please list an emergency contact (Name and Phone #). *