Medical Volunteer

We appreciate your interest in being a Medical Volunteer for the 2017 National Mall Around The World Cultural Food Festival. Given the important nature of this position, it is necessary for us to properly screen all volunteers.  

All medical volunteers must have one or more of the following medical credentials:  
MD, PA, RN, PT, ATC, NP, DPM, DO, EMT, paramedic or military corpsman.

Please fill out the questions below. Thank you for volunteering for this very important position.

NOTE: If you are NOT certified (except in the case of students training in a particular specialty), we would still love to have you as a non-medical volunteer; just go to the Individual Volunteer Signup Page and sign up there.

Please make sure you submit a photocopy of your Medical Card by email at Info@AroundTheWorldFestival with the subject "Medical Volunteer Photocopy Card" 

Name:*
Cell Phone:*
-
E-mail:*
Address:
If licensed, please select License Type*
License Number:*
License State: *
License Expiration Date:*
WAIVER: Please place your initials in the box to show you have read the above waiver and I agree to all of its terms.*
When is the best time to contact you:
Type the characters you see here:

* Indicates required fields

Volunteer’s Agreement, Waiver, Release and Acknowledgement:

I, for myself as well as for my heirs, executors, administrators, trustees, and assigns, hereby waive and release any and all rights and claims for any fatality injuries and/or damages, including, but not limited to, demands or actions for negligence, premises liability, emotional injury, intentional conduct, tort claims, and any other actions or demands of whatsoever nature I have or may have in connection with my participation as a volunteer in the Cherry Blossom Ten Mile against all sponsors of the Cherry Blossom Ten Mile and otherwise agree to hold these entities harmless. I acknowledge that I am aware of the inherent risks (physical and otherwise) involved in volunteering for the event and I voluntarily assume these risks. I further attest and certify that I am physically capable of performing the tasks required for the volunteer job(s) I have selected.”