Teen Ag Volunteer – Aldermere Farm

Participant's First Name *

First

Participant's Last Name *

Last

Participant's age (Must be between 13-17) *

Choose your afternoon (3:30-5:00 PM)

Parent/Guardian's First Name *

First

Parent/Guardian's Last Name *

Last

Parent/Guardian's Email Address *

Enter Email

Confirm Parent/Guardian's Email Address *

Confirm Email

Primary Phone *

Other Phone (optional)

How did you hear about volunteering? *

Allergies / Medical Info (If none, please enter "none".) *

Emergency Contact 1 Full Name

Emergency Contact 1 Phone

Emergency Contact 1 Relationship to Child

EC 1 Permission to Pick Up

This person has permission to pick up child.

Emergency Contact 2 Full Name

Emergency Contact 2 Phone

Emergency Contact 2 Relationship to Child

EC 2 Permission to Pick Up

This person has permission to pick up child.

Emergency Contact 3 Full Name

Emergency Contact 3 Phone

Emergency Contact 3 Relationship to Child

EC3 Permission to Pick Up

This person has permission to pick up child.

Permission to Walk/Ride Bike

I give my child permission to walk/ride bike to and from Erickson Fields Preserve.

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