La Jolla Meals On Wheels Volunteer Application 

Fields marked with an * are required

Name *
Name
Phone *
Phone
Date of Birth
Date of Birth
Indicate preference:
Team Partner's Phone
Team Partner's Phone
I/we carry auto liability coverage for $300,000 or more.
I waive any claim for damage which I may have against La Jolla Meals On Wheels, its officers, members of its Board of Directors, agents and volunteers for any act or failure to act of any of the aforementioned resulting in injury or damage to me or to my property. *