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Tutor Information Form, El Centro
Please fill out this form to volunteer for El Centro's Homework Club, 2022-2023
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Email
*
Your email
Name
*
Your answer
Phone Number
Your answer
Mailing Address
Your answer
When are you available to tutor?
Mondays, 3-4:30
Wednesdays, 3-4:30
Consent to release responsibilities. In case of an accident that involves myself, El Centro or other volunteers will contact the person indicated in the section below.
Your answer
In case that that person can’t be contacted, I authorize the doctor that is named below to treat me, and if needed, the doctor that is in the emergency room at the moment of the emergency.
Your answer
If an emergency happens, I agree to cover all the medical expenses, and I exempt CCHA and any of the volunteers for the expenses involved in this emergency by checking the box below.
Option 1
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