headerBanner
MOM-n-PA 2021


Welcome to the registration site for the eighth MOM-n-PA dental mission to be held at the Temple University, Kornberg School of Dentistry.  All Dentists, except Temple with a faculty license, must be able to upload a copy of the cover page of their professional liability insurance when registering. READING THIS ENTIRE PAGE will allow you to successfully register.


The MOM-n-PA is an annual free dental service clinic for under-served Pennsylvanians, sponsored by the MOM-n-PA Board.

  • SETUP will be Thursday September 23, 2021 at 4 PM.
  • CLINIC DAYS will be Friday & Saturday September 24 and 25, 2021.
  • BREAK DOWN will be Saturday September 25, 2021 starting at 4 PM.

STEPS TO REGISTER AS A VOLUNTEER:

1. Add our email addresses volchair@mom-n-pa.com and events@rsvpbook.com to your email contacts (the address book for the email address that you'll use for registration). This will ensure that you will receive communications from us, such as your registration confirmation and your information packet that we'll email in September.

2. Read the Temple University/ MOM-n-PA 2021 Volunteer Waiver of Liability and Release of Likeness on this page. Before you submit your registration form, you will be required to check a box indicating that you agree to the waiver.

3. Plan on filling out this registration form separately for every volunteer. Required fields, including a valid email address, are marked with an asterisk (*).

4. Choose your REGISTRANT TYPE. This will narrow down volunteer positions for you.

5. Please do not select overlapping shifts. Select either a full day, morning or afternoon shift for each day you will be attending. We'd really appreciate full day committments.

6. Click the "Submit Registration" button to submit your registration. If you don't receive an email confirmation please contact volchair@mom-n-pa.com. We have had trouble with some email providers forwarding our communications.

7. You can log back in to adjust your registration information as needed, using the password that you chose when registering. Click the "Save Changes - Attending" button to submit your edited registration.

8.  Out of state dentists without a PA license can participate this year with a Temporary Volunteer License. Click on the link  PA State Board of Dentistry to download an application. After you receive your license, email a copy to volchair@mom-n-pa.com. It may take up to 60 days to receive a license so apply early.

9.  Dental students must volunteer for full or half day time slots as registrant type "dental student not from Temple" or "Temple dental student". Temple 1st and 2nd year students will serve as patient ambassadors or interpreters and 3rd and 4th year students will serve mainly as chairside Axiom data entrants . 

10.  Pre dental students must register as registrant type "lay volunteer".

Please keep in mind that we cannot confirm final volunteer assignments until close to the event date. On rare occasions we must reassign a few volunteers to ensure proper coverage in all areas. You will be notified close to the event if we find it necessary to make adjustments to your assignment.

Hotel Reservations
A link to our hotels with discounted room rates can be found on the Volunteer page of MOM-n-PA. Please make your reservations early! 

Convenient volunteer parking will be available at the Battersby Lot at the corner of N. Broad and Westmoreland Streets. Details will be emailed in September.


Thank you so much for volunteering!




  • Temple University/ MOM-n-PA
    VOLUNTEER WAIVER OF LIABILITY AND RELEASE OF LIKENESS

    READ CAREFULLY
                By signing below, (or if registering on line by clicking YES on the registration form) the Volunteer acknowledges his or her appreciation of the risks of participating in the Mom-n-PA events.  The volunteer on behalf of themselves and their heirs hereby knowingly and voluntarily waives any right of recovery and releases Temple University, Kornberg School of Dentistry (Temple), MOM-n-PA, its officers, officials, employees, volunteers, and agents, from any and all liability, causes of action, and/or damages, no matter how characterized, including for personal injury (including death) and/or property damage arising out of undersigned's involvement with or participation in the Temple/ MOM-n-PA event.  This waiver is to include any claims of gross negligence against Temple and MOM-n-PA.  The undersigned further agrees to indemnify and hold Temple and MOM-n-PA harmless from and against any and all claims, damages, actions, liability and expenses, including attorney's fees and other professional fees in connection with any bodily injury (including death) and/or damage to property arising from or out of the Volunteer's activities and participation in volunteer services at the Temple/ MOM-n-PA events.

                The Volunteer further acknowledges and agrees that Temple and MOM-n-PA do not assume any responsibility whatsoever for any property of the Volunteer and the Volunteer shall not hold Temple or MOM-n-PA liable for any loss or damage to same.
     
                The Volunteer also grants to MOM-n-PA, Temple and their agents the right to use their picture, voice, and other reproductions of their physical likeness in connection with advertising or publicizing MOM-n-PA services and its activities in all forms of media in perpetuity.


Select Registration Mode
  • I am registering for MOM-n-PA 2021.

    I have already registered and want to edit my registration
    I forgot my password / I don't have a password
Contact
Where
  • Temple University Kornberg School of Dentistry
    3223 N. Broad Street
    Philadelphia, PA 19140
    United States
    1 (215) 707-2900
    Venue Map

    Driving Directions:
    Please use your favorite map website such as Google MapsYahoo Maps, or Mapquest and enter 3223 N. Broad Street, Philadelphia, PA 19140 to get directions to the Temple University Kornberg School of Dentistry where MOM-n-PA 2021 will be held.
Social Networking
  • facebook twitter linkedin myspace