Sleepy Tigers Volunteer Form

Sleepy Tigers Chinese Immersion Learning Center

Volunteer form
Volunteers need be at least 12 years old. Orientation & training are required by DHS, please allow 7 business days of processing time. This form works best using Google Chrome, Safari or FireFox.
Volunteer Name *

First NameLast Name
Gender*

MaleFemale
Birth Date*

MonthDayYear
Phone Number:*

Area CodePhone Number
Email:*
example@example.com
Grade: (for volunteer age under 18)
School Attending: (for volunteer age under 18)
A little about yourself:*
Language *

MandarinCantoneseEnglishSpanishFrenchGermanArabicRussianOther Language
Volunteer Schedule
From Date

MonthDayYear
Date
To Date

MonthDayYear
Date
Days of the week

MondayTuesdayWednesdayThursdayFriday
Start Time

:HourMinutesAM/PM Option
End Time

:HourMinutesAM/PM Option
Comment (or any specifics)
General Information
Home Phone*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Guardian 1’s Name*

First NameLast Name
Cell Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail*
Guardian 2’s Name

First NameLast Name
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail
Emergency Contact (other than parents)
Emergency Contact Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Emergency Contact Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
In case of an emergency or serious illness, when parents cannot be reached immediately, I hereby authorize Sleepy Tigers Chinese Immersion Learning Center to obtain emergency medical care and/or provide emergency medical transportation.
Emergency:

Clear
I hereby give the provider permission to transport in the provider’s vehicle or vehicle provided by Sleepy Tigers on field trips, with written permission in advance. (This is optional)
Transport:

Clear
Photo Release: Frequently we use photos of Sleepy Tigers Chinese Immersion Learning Center students, staff, volunteers in our school publications, flyers, advertisement and on our website. Unless you notify us at info@sleepytigers.com or 612-986-6010, photos of your child may be included in these publications.
Photo Release:

Clear
Health Information (for volunteer younger than 16)
Primary Healthcare Provider
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If unavailable, another licensed Physician may treat my child.

YesNo
Dentist:
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If unavailable, another licensed Dentist may treat my child.

YesNo
Parent/Guardian Insurance Company:
Phone Number

Area CodePhone Number
Group #
List any allergies or health concerns:*
Signature of Volunteer*

Clear
Signature of Parent/Guardian (for volunteer younger than 16)

Clear
Date*

MonthDayYear
Should be Empty:

Sleepy Tigers Chinese Immersion Learning Center