A Walk to Stamp Out Parkinson’s
Suite/ Apt #:
Experience and Education
Describe any previous experience as a volunteer, type of organization and kind of work you
Current Employer Name:
Does your current employer have (check all that apply):
Donation matching program
Program for volunteering
Your Interests at The Parkinson Council
How did you learn about Stamp Out Parkinson’s?
Other P l e a s e s p e c i f y _____________________________________
Do you have interest in volunteering at other Parkinson Council events?
Skills you would like to use while volunteering:
A Walk to Stamp Out Parkinson’s - Saturday, October 8, 2016 MLK/West River Drive
You have a choice of day-of volunteer positions! Please specify your preference(s):
Ambassador: Make walkers feel welcome and direct them to amenities (food, t-shirts etc.)
7:30 - 9:00 AM
Cheerleader: Share your energy by cheering walkers along the route. 8:00 – 11:00 AM
Set Up/Clean Up Volunteer: This is a great team-building activity for groups! May require
moderate lifting. 6:00 – 7:30 AM Set Up/ 10:30 AM – 11:30 AM Clean Up
T-Shirt Distributor: Hand out free t-shirts to all participants. 7:30 – 9:30 AM
Movement Central: Help set up for demonstrations of movement programs for people with
Parkinson’s disease (e.g. Dance for PD, Yoga). 7:30 AM – 11:00 AM
Crossing Guard: Guide walkers entering and leaving walk area at pedestrian crossing points.
7:30 AM – 11:00 AM (shifts available)
Photographer’s Assistant: Help with Walk Team photos. 7:30 AM – 11:00 AM
(Optional)Do you have any special needs or restrictions we should be aware of?
As a participant in A Walk to Stamp Out Parkinson’s, I agree to release all claims or demands against The
Parkinson Council, sponsors or any personnel for any injury I might suffer in this event. I grant full permission for
organizers to use photographs of me and quotations from me in legitimate accounts and promotions of this
Must be signed by a parent or guardian if volunteer is under 18 years of age. Please return this
form to: firstname.lastname@example.org.
The Parkinson Council s 111 Presidential Blvd, Suite 141 s Bala Cynwyd, PA 19004
Phone: 610.668.4292 s Fax: 610.668.4275 s email@example.com
Volunteered for various charity marathons around the Philadelphia area such as Philly Marathon, Hot Chocolate run etc.
Student at Drexel University
1636 S 8th st
Philadelphia PA 19148
Shelley Leung 9/21/2016