Volunteer respite program registration form

Our volunteer respite program strengthens families with children with special healthcare needs by giving the parents or caregivers a much needed break through respite events and other supportive activities, such as virtual buddies, throughout the year.

Our volunteers range in age from high school students to older adults. Volunteers under the age of 18 need to obtain parent/guardian permission prior to volunteering.

Interested in volunteering?

Please complete the following volunteer application, reviewing the following policies and indicating agreement in adhering to them on the application:

The following forms are to be completed and returned to the program as part of the application. They may be 1) scanned and emailed to volunteerrespite@chw.org, 2) Faxed to (414) 453-2538 (Attention: Volunteer Respite), or 3) Mailed to: Children's Wisconsin Community Services- Volunteer Respite, S.76th Street, Ste. 120, Milwaukee, WI 53214.

  • Background information disclosure form
  • Parental consent (if under 18)
  • Proof of Covid-19 Vaccination: Official documentation of immunizations includes any of the following:
    • CDC COVID-19 vaccine card.
    • Pediatrician, physician, or clinic documented immunizations.
    • Immunization records from a public health clinic.
    • Immunization records from a state database such as the WIR (Wisconsin Immunization Registry)
    • Military immunization records.
    • International immunization cards/Passport immunization records/WHO cards.
       

The volunteer respite program will conduct a background check on all registered volunteers. This will be of no cost to the volunteer.

Call (414) 292-4161 with any questions about the volunteer respite program volunteer opportunities.

Volunteer application

Emergency contact information

Education and experience

Interests

Acknowledgments

Antigo - (715) 627-1414
Janesville - (608) 314-9006
Marshfield - (715) 387-2729
Merrill - (715) 539-9228
Rhinelander - (715) 361-6300
Wausau - (715) 848-1457

Daniel M. Soref Family Resource Center

(414) 266-3169

Antigo - (715) 627-1414
Black River Falls - (715) 284-3001
Eau Claire - (715) 835-5915
Janesville - (608) 314-9006
Madison (KinderReady) -
(608) 442-4170
Merrill - (715) 539-9228
Milwaukee - (414) 453-1400
Rhinelander - (715) 361-6300
Stevens Point - (715) 341-6672
Wausau - (715) 848-1457

Parent Education (Milwaukee) -
(414) 453-1400

Parenting Classes (Portage County) - (715) 341-6672

Respite Care (Milwaukee) -
(414) 453-1400