Coverage Needed

Call for Volunteers
From July 28th to August 1st, the David L. MacIntosh Sport Medicine Clinic of the University of Toronto will be providing medical and therapy coverage for the Canadian Track and Field Championships taking place at the university’s Varsity Centre. It’s an exciting prospect and we want you to get involved.
We are looking for first aiders, first responders (including student therapists!), Athletic Therapists, Chiropractors, Massage Therapists, Physiotherapists and Sport Physicians. If you think you’ve got what it takes, we’d love to hear from you.
What it takes
If you’re interested in volunteering for one or any of the following games, read on.
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We're looking for volunteers who are available for a minimum of a 4 hour shift from July 28-August 1st. We encourage everyone to apply, but please keep in mind that the more time and flexibility you have, the more opportunities there may be for you to get involved.
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We’ll be using electronic communication (i.e. the volunteer website, e-mail etc.) to pass along important information. You’ll need your own valid e-mail address and access to the Internet.
What you need: required documentation
The application form below takes about 5 minutes to complete. Here’s the information you’ll need to have handy to fill out the application.
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Emergency contact information and a valid email address
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please designate what your preference of work is: that is, clinical or field work
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you will receive a confirmation of your work hours on July 20th and you will receive a letter of hours that you worked to use for your professional portfolio
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you will receive lunch and a uniform
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all medical, therapy and emergency cares supplies will be provided
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Please forward your completed volunteer application form to andrea.prieur@utoronto.ca or the fax number below:
DEADLINE FOR SUBMISSION: July 19th, 2010
VOLUNTEER APPLICATION
Name:
Address:
E-mail address:
Birth date:
Phone Number: Home: Office: Mobile: Other:
When is the best time to reach you?
Emergency contact:
Name/Relationship:
Emergency Contact Phone Number:
Provider Category (check any / all that apply):
Sport Physician Sport Chiropractor
Certified Athletic Therapist Sport Physiotherapist
Sport Massage Therapist
First Aider / First Responder / Student (specify details: )
Please which type(s) of work you are interested in performing:
Field Care (on site emergency coverage at the track / field)
Clinical Care (assessing / treating athletes in a clinic beside the track)
Do you have previous experience working with Track and Field?
Yes No If “Yes”, please specify:
Do you have previous experience working at provincial, national, or international games or events in any sport(s)?
Yes No If “Yes”, please specify:
List any other skills, training or qualifications you have that may be an asset in this situation: i.e current first aid or first responder
Please enter whatever dates and times you are able to commit to working.
Event
Date
Time
Your Coverage Choice(s)
Canadian T&F Championships
July 28-Aug 1
7am- 9pm
*The more availability, the more opportunity!
By signing below, I agree to indemnify, defend, and hold harmless the David L. MacIntosh Sport Medicine Clinic and the University of Toronto, and their respective employees, agents, and representatives, from and against all claims, demands, causes of action, losses, costs, and expenses (including reasonable fees) arising as a result of my negligence or willful misconduct, or bodily injury and property damage resulting from or incident to my involvement with any of the above listed events to be held at the University of Toronto.
This signature also verifies that I am allowed to practice in Ontario and that I hold professional malpractice insurance.
________________________________________________________________ Volunteer’s Signature
Date
Please fax your completed volunteer application and appended documentation to:
Andrea Prieur, Head Therapist David L. MacIntosh Sport Medicine Clinic University of Toronto fax # 416-971-2846 or email to andrea.prieur@utoronto.ca