Survey - Volunteer Registration 2023 - Lowell General Hospital Employee - TeamWalk

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Question - Required - Where would you like to be stationed?
You may select more than one

	Set Up 6:00 a.m. - 9:00 a.m. (10 people needed)
	Starting Line/Finish Line Cheerer 9:00 a.m. to 12:00 p.m. ~ Reserved for Cancer Center Employees
	Registration/ Incentive Pick Ups 7:30 a.m. to 9:30 a.m. (12 people needed)
	Route Cheerer (Various spots along the route to cheer on the walkers) 9:00 a.m. - 11:30 p.m. (If you have a preferred spot along the route, please fill in Other box below) (80 people needed)
	Refreshment Tent 9:30 to 12:00 p.m. (12 people needed)
	Clean Up 11:00 a.m. - 1:30 p.m. (6 people needed)
	Other (Please describe your position or route preference in the box below)

Question - Not Required - Other (Please note, there will only be the 3-mile route.):

Please provide your contact information below:


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
	Phone Number:
	Gender:
*	Date of Birth: Required	Date of Birth:
	I would like to receive the TeamTalk newsletter.
	Email Format:

Question - Not Required - Guardian Name (if under 18 years old):

Question - Not Required - Guardian Phone Number:

Question - Not Required - As the guardian, I permit the minor listed above to volunteer at TeamWalk for CancerCare:

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Question - Required - Have you volunteered at TeamWalk in the past?

Question - Not Required - Please list anyone you would like to be stationed with:

Question - Not Required - Please let us know of any physical limitations you might have

Question - Not Required - Do you need a new volunteer shirt for TeamWalk 2023?

Question - Not Required - If you do need a new t-shirt for 2023, what size do you need?