CCWAA September 16th & 23rd, 2017

The Conquer Chiari Walk Across America is an annual fundraising and awareness event comprised of a series of local walks held on the 3rd and 4th Saturday in September.

In 2016, the event was held at 85 locations, involved more than 11,000 participants, and raised over $500,000 for research and other patient centered programs. The 10th annual walk will be held on September 16th & 23rd 2017. As always, it is our goal to have at least one walk in every state, and for 80% of the money raised going towards research, education, and awareness.


Please note that we generally keep a distance of no less than 75 miles between walk sites.
At times, we do receive multiple applications for a general area.
If this happens we do our best to match volunteers with an existing walk site.

Organizer PDF Summary

Contact Information
Name:
Address:
 
Walk items will be delivered to this address, No PO BOXES please.
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Internet access is mandatory. Organizers and Staff utilize Facebook for communication
Alternate Organizers:
  Name Email Phone
1.
2.
Identify someone who is willing and capable to take over as organizer if you are unable to continue, include contact info.

Desired Walk City
City you wish to hold walk in:

Background & Experience
Professional Background:
Volunteer Experience:
Connection to Chiari:
Time Available for Walk Duties:

A successful walk depends on a number of factors, such as the ability to sign corporate sponsors.
Please answer the following:
How Many People Are In Your Social Network In The Walk Area?
How Many Businesses In The Walk Area Do You Have Contacts In?
I Am Willing And Able To Pay For Incidental Costs Out Of Pocket

Being a successful organizer depends on a number of skills and traits.
Please rate yourself on the following:
Planning & Organizing:
Fostering Teamwork:
Overcoming Obstacles:
Handling Conflict:


Code of Conduct, Waiver, and Release

The C&S Patient Education Foundation is a 501(c)(3) non-profit organization doing business as “Conquer Chiari,” and dedicated to improving the experiences and outcomes of Chiari and syringomyelia patients through education, awareness, and research. Volunteering on behalf of the organization subjects you to the observance of the organization’s rules and procedures, including without limitation the following:

As a volunteer I agree to;

  • Treat staff members, other volunteers, and participants with dignity and respect.
  • Act responsibly on behalf of Conquer Chiari towards the communities served.
  • Act responsibly and respectfully on behalf of Conquer Chiari on all social media sites in all dealings with your walk and/or Conquer Chiari.
  • Act honestly and with integrity in all dealings with Conquer Chiari.
  • Appropriately handle conflicts with staff members, volunteers, or participants.

These acts are strictly prohibited.

  • Abusive language towards a staff member, board member, volunteer, or participant.
  • Discourteous or rude behavior to a staff member, board member, volunteer, or participant.
  • Verbal, physical, or any other form of harassment of a staff member, board member, volunteer, or participant.
  • Actual or threatened violence toward any staff member, board member, volunteer, or participant.
  • Bullying of any staff member, board member, volunteer, or participant.
  • Failure to reasonably cooperate with a staff member, board member, volunteer, or participant.

I have read and I understand the C&S Patient Education Foundation’s Code of Conduct. I agree to abide by the rules above and I understand that I may be removed as a volunteer if I violate any of these rules.

By signing this form, I hereby certify that I am undertaking this project as an unpaid volunteer and will derive no material benefit, cash or otherwise, from the fund-raising activities associated with the walk. I further certify that all funds raised will be for the benefit of C&S Patient Education Foundation (Conquer Chiari), and that I will comply with all Conquer Chiari guidelines and relevant local, state, and federal regulations. I further agree that I have read and understand my responsibilities as a Site Organizer and/or volunteer and I understand that Conquer Chiari can terminate my fund-raising on the organization's behalf at any time.

I agree with this Code of Conduct, Waiver, and Release

18 Years and Older
In checking this box, I confirm that I am 18 years or older.

  

Thanks for your support!

Rick Labuda, Executive Director
director@conquerchiari.org
724-940-0116