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What's your email address?

Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for KIDS Center volunteer activities, including shift reminders and cancellations.

To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
Street Address *
City *
State *
Zip code *
Date of Birth *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Emergency contact name: *
Emergency contact number: *
Can you lift 25+ lbs? *
We offer various volunteer opportunities throughout the year. If you're interested in supporting us, What days are you typically available to volunteer?










Please select any skills/interests you're able to offer our organization:





Disclaimer


Who is this registration for?

Volunteer Release and Agreement

I certify that all the information that I provided is true and complete to the best of my knowledge. I certify that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information I have submitted will be verified by KIDS Center and that misrepresentation or omissions may be cause for immediate rejection of my application for termination of my position as a volunteer. I grant KIDS Center permission to complete a background/criminal history check and understand that my ability to volunteer is contingent upon information obtained. My acceptance of this release will be marked by my signature below.

Volunteer Waiver and Agreement

As a volunteer and participant in the 2024 Cork & Barrel benefitting KIDS Center, I fully understand and agree to the following:
I recognize and acknowledge that I assume full risk of any injuries, property damage or loss which I may sustain, as a result of my participation in any and all activities connected with or associated with Cork & Barrel and KIDS Center (Kids Intervention & Diagnostic Service Center, Inc.). I agree to waive and relinquish all claims I may have against Cork & Barrel, KIDS Center (Kids Intervention & Diagnostic Service Center, Inc.), Central Oregon Community College (COCC), and any agents thereof from any and all claims by other parties resulting from injuries damages or loss caused by my actions, in any way associated with the activities of KIDS Center and the Cork & Barrel event. I fully understand that, as a volunteer for Cork & Barrel benefitting KIDS Center, I represent the community and the family-oriented KIDS Center atmosphere, and I must be sober and not under the influence of any intoxicating substances when arriving to my volunteer shifts and therefore may not consume any intoxicants during my shifts. My acceptance of this will be marked by my signature below.



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