© 2019 Riverside Marketing, LLC

Volunteer Registration

Volunteer Registration has been extended to January 22nd.

Mandatory Training (must attend at least one)

Volunteer/Buddy Training

Saturday, January 18th

10 am - 11:30 pm

Make-Up Volunteer/Buddy Training

Tuesday, January 21st

6:00 - 7:30 pm

Thank you for being a part!

Volunteer First Name

Last Name

Age/DOB

Gender

Female

Male

Address

City

State

Zip Code

Email

Phone

Parent Name (If under 18)

Parent Phone (If under 18)

Emergency Contact During Event (If under 18)

Emergency Contact Phone (If under 18)

Background checks are required for ALL volunteers over the age of 18. Have you been through the Covenant Life Center background check or completed one within the last 12 - 18 months?

Yes

No (To complete, you can find the link at the bottom of this page)

If yes, please upload or email to our team at info@clcvictoria.org.

Upload Here

Upload supported file (Max 15MB)

If you are between the ages 14 - 18, a permission slip signed by your parent/guardian is required to volunteer. To complete permission slip, download it at the bottom of this page for a copy of the volunteer permission.

Yes, I am under the age of 18.

No

Former Special Needs Skills/Training (please check all that apply):

Fluent in American Sign Language (ASL)

Special Education Teacher

Current Volunteer in Special Needs Ministry

Other

If you're a Healthcare Professional, please list field:

If other, please explain:

I Have Volunteered at Night to Shine Before:

Yes

No

Volunteer Role Requested (Please number your top three choices. We will consider your request but cannot guarantee a specific role):

Bathroom Attendant

Buddy (We need 150 people to be a ‘Buddy’. They will accompany and assist assigned honored guest throughout the evening, providing companionship and any assistance the may need during the event. Sit with their guest during dinner and engage with them in conversation. Must be at least 16 years old. Buddies can dress in prom attire.)

Parking

Safety (please let us know if you are an authorized member of local law enforcement)

Limo Team

Registration

Additional Notes or Concerns:

Every volunteer must fill out a media release form for this event. By checking this box you agree to completing the media release form below and returning it our team.

To complete the background check a fee of $12 is required. If you are financially unable to make this payment, then please select yes. You can find both links to either background check options at the bottom of this page.

Yes, I need assistance with fee.

No, I do not need assistance.

If you selected to be a Buddy and would like a specific honored guest, then please list name here:

Thanks for submitting! Check your email for confirmation.

Volunteer Background Check

Parent Permission Slip

Media Release Form

Volunteers are required to fill this out.

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