Medical Volunteer Form

Thank you for your interest in becoming a Cornhusker State Games medical volunteer! The safety and well being of the athletes is priority number one, and it’s because of people like you, that it’s possible to conduct a safe and successful Games.

All medical volunteers will receive a Cornhusker State Games medical shirt, passes to the Opening Ceremonies (Friday, July 19) and a $15 gift card to Casey's. Free lunch will be provided at all sites where volunteers are needed. If you have any questions, email info@nebraskasportscouncil.com or call 402-471-2544.

Medical services provided by:		Contributing medical partner:

Volunteer Info:
* First Name:
* Last Name:
Address:
City:
State:
ZIP:
* Primary Number:
Mobile Number:
	I would like to receive text alerts regarding volunteer information.
* Email Address:
* Shirt Size:	-- Please Select -- Youth 6-8Youth 10-12Youth 14-16SmallMediumLargeX-LargeXX-LargeXXX-Large
* Professional Title:	-- Please Select -- ATCDCEMTLPNMDPAParamedicPTRNRTOtherNone
Available Dates & Times: Volunteers will be assigned 4-6 hour shifts based on their available dates and times.
Friday, July 19   Available From: -- Select Time -- 7 am8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm   To: -- Select Time -- 8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm9 pm Saturday, July 20   Available From: -- Select Time -- 7 am8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm   To: -- Select Time -- 8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm9 pm Sunday, July 21   Available From: -- Select Time -- 7 am8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm   To: -- Select Time -- 8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm9 pm Saturday, July 27   Available From: -- Select Time -- 7 am8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm   To: -- Select Time -- 8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm9 pm Sunday, July 28   Available From: -- Select Time -- 7 am8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm   To: -- Select Time -- 8 am9 am10 am11 amNoon1 pm2 pm3 pm4 pm5 pm6 pm7 pm8 pm9 pm
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