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PCR Volunteer Application

Tips:

1) If you have applied for volunteer work at PCR in the past and have received an ID#, contact volunteer.pcrnyc@gmail.com

2) This application has 3 parts: Volunteer Application, Medical Release Form, and Photo Release Form.

3) If you are below the age of 18, you will need your parent/guardian's signature.

    If you are below the age of 14, you will need parent/guardian supervision at events.

VOLUNTEER GENERAL INFORMATION

Tips for students:

Don't use a school email. Those disable when you graduate.

If you do not have a phone number or email address, use your parent/guardian's. If you need to update your information, contact volunteer.pcrnyc@gmail.com

What language(s) do you speak fluently?
EMERGENCY CONTACT
CERTIFICATION
PCR Medical Release Form

This authorization is intended to give Parent-Child Relationship Association (PCR) the right to give consent to not only authorization for emergency diagnostic procedures, medical, dental, surgical care and hospitalization, but for any diagnostic, medical, dental, surgical care and hospitalization that the person so designated deems advisable, and which the physician, dentist, or hospitalization personnel in said person’s judgement may deem advisable.

It is intended that this document be presented to the physician, dentist, or appropriate hospital or medical representative at such time as the medical, dental, surgical care, or hospitalization shall be authorized. It is intended that the authorization relieve the physician, dentist, person rendering from the failure of me, the parent or guardian of the above-named minor, from signing a consent or authorization to render such care. It is the intent that PCR shall act in my stead in making such decisions

Thank you for submitting! If there are any issues, we will contact you.

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