Volunteer

Subsections:

Volunteer

Volunteer Information

Medical Team Registration Form

Volunteer Orientation

Contact Us

Get Involved as a Medical Team Volunteer

The 2005 Summer National Senior Games - The Senior Olympics recruited health care professionals to staff its medical team during the Games, June 3-18, 2005. Medical team members were needed to provide coverage at competition venues in the Pittsburgh area.

All medical volunteers were encouraged to pre-register. To become a medical team volunteer, folks completed and submited the electronic form below.

Name*

Address*

City*

State*

Zip Code*

Home Phone*

Work Phone

Mobile Phone

E-mail*

T-Shirt Size*

Profession*

MD	EMT
DO	ATC
LPN	Massage Therapist
RN	Other:

Specialty*

Emergency	CCU/ICU
Orthopedic	Anesthesia
Internal Medicine	Sports Medicine
Family Practice

Do you have your own professional liability insurance?*

Yes No

If "yes" and if you are a private practitioner, please mail or fax a certificate of insurance. Your insurance carrier/risk manager must verify on the certificate that your participation with the Senior Games is covered.

Days Available (check all that apply)*

Monday Dates:	Tuesday Dates:	Wednesday Dates:
Thursday Dates:	Friday Dates:	Saturday Dates:
Sunday Dates:

Times Available*

All shifts are four (4) hours (check all that apply)

Morning

Afternoon

Evening

Venue Preference (check all that apply)*

Archery	Badminton
Basketball	Bowling
Cycling	Golf
Horseshoes	Race Walk
Racquetball	Road Race
Shuffleboard	Softball
Swimming	Table Tennis
Tennis	Track & Field
Triathlon	Volleyball

Please indicate your venue interest if it is not listed above

* = Required Field

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