STEP 1. To prevent your confirmation email from going into your SPAM filter, add to your email contact list. Please ensure that you enter your email CORRECTLY into the registration form, as this is a very common mistake.

STEP 2. Every volunteer will need to complete the registration form individually and a legal parent or guardian will need to complete it for volunteers that are 16 or 17 years old.

STEP 3. You will not be able to go back in and change your registration, so register only for the sessions and meals you plan to work and attend. However, situations come up, so please address any changes to your registration via the email link that is provided in your registration confirmation.

Kansas Mission of Mercy Volunteer Service Agreement

The undersigned, on behalf of themselves and their estate, hereby waives any right of recovery and releases the Kansas Dental Charitable Foundation (KDCF), their officers, officials, employees and agents, from liability related to the undersigned, arising from any and all injury to persons and damage to property, and further agrees and undertakes to indemnify, hold harmless and defend the KDCF from and against any and all claims, damages, actions, liability and expenses including attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or damage to property arising from or out of the undersigned’s activities and participation in volunteer services at the above Kansas Mission of Mercy.

The undersigned further acknowledges and agrees that the KDCF does not assume any responsibility whatsoever for any property of the undersigned and the undersigned shall not hold the KDCF liable for any loss or damage to same.

The Kansas Dental Charitable Foundation requires that all volunteers have current health insurance. The KDCF also requires that all volunteers at the KMOM Clinic be at least 18 years of age unless accompanied by a parent or a guardian. Individuals who are 16 and 17 years old may volunteer, but must be accompanied by a parent or guardian during the KMOM event and no volunteers will be permitted under the age of 16. Additionally, no volunteer under the age of 18 will be permitted to work on the clinic floor.

By completing and submitting this form, the undersigned certifies that he or she is at least 18 years of age, or is the legal parent/guardian registering a 16 or 17 year old volunteer, and has read this Volunteer Service Agreement and agrees to its terms and conditions.

By completing and submitting this form, the undersigned also grants to the Kansas Dental Charitable Foundation and its agents the right to use their picture, voice and other reproductions of their physical likeness in connection with advertising or publicizing Kansas Mission of Mercy services and its activities in all forms of media in perpetuity.