Information Clearance

• New Jersey WAVE
• Non-medical volunteer form
• Information clearance form
• Parental consent form
• Photo consent form
• Participant application form
• Volunteer application form
• WAVE medical clearance form

Print and mail completed form to:

New Jersey WAVE

c/o Voorhees Pediatric Facility

Attention: Tricia Cunningham

1304 Laurel Oak Road

Voorhees, NJ 08034-4392 

I agree to allow the Wave staff to review the personal and

medical information contained in this packet.  I also agree

to have this information reviewed by the physicians

providing medical clearance for WAVE getaway

participation.

_____________________________                 _________

(Applicant)                                                              (Date)                                                                                  

____________________________                 ___________                                                                          

(Parent)                                                                  (Date)