Sleepy Tigers Summer School Volunteer Form

Sleepy Tigers Chinese Immersion Learning Center

Summer School 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 Name Last Name
Gender *

Male Female
Birth Date *

Month Day Year
Phone Number: *

Area Code Phone Number
Email: *
example@example.com
Grade: (Age under 18)
School Attending: (Age under 18)
A little about yourself: *
Language *

Mandarin Cantonese English Spanish French German Arabic Russian Other Language
Summer Volunteer Schedule
From Date

Month Day Year
Date
To Date

Month Day Year
Date
Days of the week

Monday Tuesday Wednesday Thursday Friday
Start Time

: Hour Minutes AM/PM Option
End Time

: Hour Minutes AM/PM Option
General Information
Home Phone *

Area Code Phone Number
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Guardian 1’s Name *

First Name Last Name
Cell Phone *

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail *
Guardian 2’s Name

First Name Last Name
Cell Phone

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail
Emergency Contact Person (other than parents)
Emergency Contact Name

First Name Last Name
Relationship
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Relationship
Phone Number

Area Code Phone 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 for my child.
Emergency:

Clear
I hereby give the provider permission to transport my child 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 612-568-8819, photos of your child may be included in these publications.
Photo Release:

Clear
Primary Healthcare Provider:
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Yes No
Dentist:
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Yes No
Parent/Guardian Insurance Company:
Phone Number

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

Clear
Signature of Parent/Guardian *

Clear
Date *

Month Day Year
Should be Empty:

Sleepy Tigers Chinese Immersion Learning Center