Complete the form below to join our volunteer team!
Date of Birth
(if different from parent/guardian)
Please list times for each day of the week that you are available. (Actual commitment time will be determined during interview with the Coordinator of Volunteer Services.)
I agree to abide by the requirements and regulations of Palisades Medical Center and the service to which I am assigned. I will serve a minimum of sixty hours (60) after participating in required training. Letters of recommendation or acknowledgement of Volunteer Service will not be issued prior to completion of 60 hours of volunteer service.
My son/daughter is 15 years of age or older, has successfully completed the first year of high school, and has my permission to volunteer at Palisades Medical Center. I realize the responsibilities of this position and will cooperate to help him/her to comply. I authorize Palisades Medical Center and the Palisades Medical Center Foundation to use my son's/daughter’s name and/or photograph in marketing materials to help promote Volunteer Services at Palisades Medical Center.
In the event that my child becomes ill or injured while volunteering and I cannot be reached, I hereby give my consent to have him/her treated by a staff physician.