Scroll to see more shifts & complete your submission at the bottom of the page.Click here to scroll down.
Required fields are marked with an asterisk (*). First Name *
Last Name *
Mobile Phone Number: *
For example, 123-456-7890
In which department do you work? Please include hospital or clinic name. *
What are your Medical Credentials? *
What is your specialty? *
If you have volunteered for CIM before, which location were you assigned to?
Indicate the location you would prefer to be assigned to volunteer in 2024. If you do not have a preference, leave blank
Please list all your expertise and experience you think would be helpful in assisting us with placing you in a volunteer location: *
Please list an emergency contact person and their cell phone number: *
What is the name of your CERT organization? *
What is your current CERT level certification? *
Have you used a hand-held or desktop two-way radio for medical communications in the past? *
If you volunteered for an ON-COURSE aid station and are willing to be a captain, please enter your name here. An on-course captain may be required to pick up the medical bag prior to the event.
Shelby Greenlow: shelby.greenlow@gmail.com
Disclaimer
As consideration for being permitted by SLDRA (SRA), and the organizations, cities and counties in which the race is contested, (herein collectively referred to as "Promoters and Sponsors") to volunteer at the CALIFORNIA INTERNATIONAL MARATHON/RELAY CHALLENGE(CIM) , I hereby agree that I, my assignees, heirs, distributees, guardians and legal representatives will not make a claim against, sue or attach the property of the Promoters and Sponsors, for any and all injuries or damage arising from my participation as a volunteer at CIM. I also give free use of my name and/or picture in any broadcast, telecast, or other account of this event. I further acknowledge that if I am signing this Volunteer Relase/Agreement on behalf of a minor person ("Minor") I have such legal capacity and authority to act on behalf of the Minor and bind the Minor to this Official Volunteer Release/Agreement.
As consideration for being permitted by SLDRA (SRA), and the organizations, cities and counties in which the race is contested, (herein collectively referred to as "Promoters and Sponsors") to volunteer at the CALIFORNIA INTERNATIONAL MARATHON/RELAY CHALLENGE(CIM) , I hereby agree that I, my assignees, heirs, distributees, guardians and legal representatives will not make a claim against, sue or attach the property of the Promoters and Sponsors, for any and all injuries or damage arising from my participation as a volunteer at CIM. I also give free use of my name and/or picture in any broadcast, telecast, or other account of this event. I further acknowledge that if I am signing this Volunteer Relase/Agreement on behalf of a minor person ("Minor") I have such legal capacity and authority to act on behalf of the Minor and bind the Minor to this Official Volunteer Release/Agreement.
Check here to show you accept the terms stated above for yourself or for a minor Volunteer for which you are the parental guardian.
