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Name(Required)

First Last

Email(Required)

Phone(Required)

Current Occupation/Employer

Date of Birth(Required)

*All volunteers must be 18 years of age or older and must pass a background check due to the vulnerability of our interns.

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

How did you hear about The Lily Pad Cafe?

Do you have experience as a volunteer and/or working with adults with disabilities? If yes, describe below.*(Required)

Do you have any physical limitations? If yes, please describe.*(Required)

Do you hold any CPR or First Aid certifications?

Availability(Required)

I would like to volunteer at:(Required)

Please list two references with name, relationship to you, email address, and phone number.(Required)

Please list your emergency contact's name and phone number(Required)

Waiver and Release(Required)

I consent to the waiver and release stated below.

As a volunteer of The Lily Pad Foundation. I agree to act as a representative of the organization. In doing so, I understand that I am a reflection of the The Lily Pad Foundation. mission and brand. I agree to conduct myself within the mission and principles of the The Lily Pad Foundation organization while performing my volunteer responsibilities. I understand that I will be volunteering at my own risk and that The Lily Pad Foundation, its board of directors, or its employees cannot assume any liability for any accident, injury, or health problem which may arise from any volunteer work I perform. I agree that all of the work I do is on a volunteer basis and that I am not eligible to receive any compensation.

Phone

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Join the Lily Pad Family

Job Coaching | Events | Fundraising

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