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Susan G. Komen Greater Kansas City - Volunteer Survey Update

We want you to help us have a great impact in the fight against breast cancer throughout our service area! Please fill out the volunteer survey below so we can best match your skill set with our needs in the future! Thank you for your interest in working with Komen Kansas City!

  Volunteer Application
Question - Required - Date

2. Your information:
















Date of Birth:











Question - Required - Please indicate if you have more than one year of experience in the following areas: (You may select multiple areas)

Question - Not Required - How often would you like to volunteer?




Question - Required - I am interested in:


Komen Volunteer Release
Emergency Contact:





I wish to volunteer for Susan G. Komen Greater Kansas City Affiliate. I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this, I hereby assume full and complete responsibility for any personal injury and/or property damage that I may sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless & covenant not to file suit against the Komen Affiliate, Susan G. Komen and of their employees, volunteers, partners, agents, Sponsors, Board Members and Successors from any and all loss, liability or claims I may have arising out of my service as a volunteer. I understand that as a volunteer, I may become privy to confidential information about the Komen Affiliate or Susan G. Komen. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about the Komen Affiliate’s or Susan G. Komen’s internal procedures, business operations, personnel information and the like that is not otherwise publicly disclosed by the Komen Affiliate or Susan G. Komen. I will not use any confidential information in any manner that would be detrimental to the Komen Affiliate or Susan G. Komen, and I will avoid any actions that might impair the reputation of the Komen Affiliate or Susan G. Komen.


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