Welcome to the Special Olympics Michigan Volunteer Website

Please fill out this form if you want to volunteer with us as a MEDICAL Volunteer for the 2019 State Basketball Finals.

2019 State Basketball MEDICAL VOLUNTEERS

Special Olympics Michigan
2019 State Basketball Finals
March 15-16, 2019
Grand Rapids, MI
MEDICAL VOLUNTEER REGISTRATION
Medical Volunteers must be 18 years old or older with current CPR & First Aid certifications
First name
Middle name
Family/last name
DOB
Gender
Comments
Home address
Line 1
Line 2
City
State
Zip/postal
E-mail
Home phone
Work phone
Mobile
I would like to participate in the medical coverage for the State Fall Games
Please check the appropriate items below:
1. Professional Position
Physician
Nurse
EMT
Other (Specify)
Paramedic
Certified Athletic Trainer
Athletic Training Student
*please attach a copy of your certification of license in your Medical Field (If you have not done so in the past)
2. I have certificates in:
CPR
First Aid
AED
3. I would like to volunteer on the following days:
Friday March 15
Saturday March 16
1:30pm-8:00pm (tentative)
8:00am-4:00pm (tentative)
**Housing is not available**
I grant permission for Special Olympics to use my likeness, voice, and words in TV, radio, newspapers, magazines, and other media for the purpose of communicating the mission and activities of Special Olympics and/or applying for funds to support the mission and activities of Special Olympics.