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First Name *

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I have the following certifications:

Article 9

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A background check and/or a fingerprint clearance card may be required for volunteers accepting positions that involve direct contract with our members. I consent to a background check. *

I agree

Waiver Statement *

In consideration of me and/or my minor child being permitted to participate in Down Syndrome Network (DSNetwork) events and programs, I hereby for myself, my heirs, and personal representatives assume any and all risks that might be associated with the event. I further waive, release, discharge and covenant not to sue DSNetwork, its programs, officers, employees, sponsors, organizers, volunteers, or other representatives or their successors and assigns, for any and all injuries or damages of any kind whatsoever suffered by myself and/or my minor child as a result of taking part in the event and any related activities. I also authorize the use by DSNetwork and their programs of any photo, film, or videotape taken of me and/or my minor child at the event for any purpose.

Parent/Guardian Information (If applicable)

Volunteers must be at least 16 years old or accompanied by a parent/guardian. If you are under age 16, please complete this section.

Parent/Guardian First & Last Name

Parent/Guardian Email

Parent/Guardian Mobile Phone

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Find out how you can give and get back on your Arizona state income tax return. It's an easy way to support DSNetwork. AZ Charitable Tax Credit
DSNetwork EIN: 61-1409048 | AZ QCO #20262

Down Syndrome Network Arizona
Enrichment Center
1445 E Guadalupe Rd, STE 103, Tempe AZ 85283
480-759-9150 (call/text) | info@DSNetworkAZ.org