If interested in volunteering for Respite Night, please complete and submit this form. Respite Night contact is Danelle Mills, email@example.com, (402) 483-7635. If you have problems with completing this online registration form, please contact Danelle to provide your info directly to her.
Best phone number to reach you*
Best e-mail address to reach you*
Please pick the volunteer job(s) you would like to do. You may choose up to 3 options.
Volunteer jobs/ not working with children:
Volunteer jobs/ working with children:
Please provide this additional info to help us choose your child with special needs:
Physical limitations you have that may limit your ability to care for a child with special needs
Special skills or training you have that would aid in your care for a child with special needs
All volunteers, 19 years or older, need to complete a Background Check form. This form is valid for two years. If you are a returning volunteer, your Background Check form is valid if it was completed on/before October 20, 2017.
Click here to open Background Check form in a new window. You will then be able to complete/submit Background Check form online and then return to this registration page to complete the registration process.
All Background Check forms must be received on/before October 18, 2017 for volunteers planning to serve at October 20 Respite Night.