Volunteer Application

Contact Information
Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address

Special Skills, Qualifications, or limitations

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports. Please list any limitations that you have such as not being able to stand for long periods of time.

Previous Volunteer Experience

Summarize your previous volunteer experience.

Person to Notify in Case of Emergency
Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address

Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. If you (the volunteer) are a minor-your guardian/parent must sign too.
Name (printed)
Signature
Date
Release of Liability
In consideration of the furtherance of the Village of Tequesta purposes, objectives and work, and in consideration of the Village of Tequesta permitting me to participate as a volunteer, on behalf of myself, my heirs, executors, administrators and assigns, I hereby waive and release any and all rights and claims for damages I may have against the Village of Tequesta as well as any other person connected with the Village of Tequesta, their heirs, executors, administrators and assigns for any and all injuries and liabilities I may suffer while performing volunteer services for the Village of Tequesta or as a result thereof. I give permission for the Village of Tequesta to use my photograph for publicity purposes. Signature Signature of parent/guardian