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The Asthma Foundation of Western Australia

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Major Partner of the
Asthma Foundation of WA




Proudly supporting the
Asthma Foundation of WA

2010 HBF Freeway Bike Hike for Asthma
Volunteer Registration Form

*** UPDATE 12/3/2010 - ROUTE MARSHALS NEEDED ***
 We have managed to fill most positions but still require over 100 Route Marshals!  This crucial role involves monitoring riders and reporting through via two-way radio if assistance is required.  Route Marshals will meet at Belmont at 6:00am to pick up their two-way radio and then dropped by bus at key points along the Mitchell Freeway.  Once the ride has finished, the bus will return to pick them up and drop them back at Belmont Racecouse.  This should be at approximately 12:00pm.

Thank you!

PERSONAL INFORMATION AND CONTACT DETAILS
Title:
Given name/s:
Surname:
Date of Birth: (Volunteers must be over 16 years of age)
Address:
 
Suburb:
Postcode:
Contact Number:
Email:
In case of an emergency, please contact:
Name:
Relationship:
Phone:


The Asthma Foundation of WA is a proud supporter of the "refer a friend" initiative. As a sign of appreciation, the Foundation will be giving away a brand new bike to one of our outstanding volunteers on the day. To go into the draw, simply get a friend to sign up online, listing your name down as having referred them. Each referred friend that signs up and volunteers on the day gets you an entry into the draw ... the more people you refer, the greater your chances of winning!
REFERRED BY:


EVENT DETAILS
Have you previously volunteered with the Asthma Foundation of WA?:
If yes, with what event and in which position?
Please list your preferred positions for the day:
1st:
2nd:
3rd:
Please indicate your shirt size:


HEALTH
Please provide details of any previous or current medical condition or restriction, physical or otherwise, which may affect your ability to perform delegated voluntary tasks
Any additional comments

© Asthma Foundation of Western Australia 2009