North Whidbey Pool, Park, and Recreation District Volunteer Application

Legal Name*

First NameMiddle and Last Name

List other names you have gone by.*

Date of Birth*

MonthDayYear

Drivers Licenses Number*

Home Phone Number*

Area CodePhone Number

Cell Phone Number*

Area CodePhone Number

Work Number*

Area CodePhone Number

Best Contact Number*

HomeCellWork

Cell Phone Carrier*

May we text you?*

YesNo

Best Time to Call*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How many years have you lived at the above address?*

Please list all former address and how long you live at each address.*

Example: 85 SE Jerome St., Oak Harbor, WA 98277 3.7 years.

T-Shirt Size*

Place of Employment*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Length of Employment*

Emergency Contact *

Emergency Contact Phone Number*

Area you are volunteering in?*

Youth Aquatics and SportsActive Older AdultsOther

List Any Leadership/Volunteer Experience You Have Had:*

List any training, education or skills that will help you in your volunteer capacity.*

List past volunteer service, length of service and their contact information.*

Example: John Doe Park District. 2 years, Basketball Coach, Jane Doe 000-000-0000.

At the end of their service volunteers can be provided with a letter confirming the total hours of their service. NWPPRD requires that if a volunteer commits' to a position that they complete the entire commitment for the length of the program except in the case or emergency or sudden deployment. Are you able to commit for the entire length of the program?*

YesNoUnsure

If you marked "unsure" please explain below.*

Within the last seven years, have you been convicted of a violation other than a minor traffic offense? *

YesNo

If you answered "Yes" above please explain the date and nature of offense. *

A "Yes" answer does not automatically disqualify you from volunteering, since the nature of the offense, date, and the position for which you are applying is also considered.

Personal References (Must Be 18 Years Old and Not Related to You.)

Reference Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I hereby certify that the information on this application is accurate and complete. I authorize North Whidbey Pool, Park, and Recreation District (District) to verify all of the information deemed necessary from employers and personal references to determine my suitability for the volunteer position I am seeking with the District. I have not been promised and have no expectation of compensation for services rendered and offer my services freely and without pressure or coercion, direct or implied, from the District. I hereby release North Whidbey, Pool, Park, and Recreation District, its employees, officers, directors, and agents from any claims, lawsuits, or actions my heirs or legal representatives may have for any personal injury and/or property damage I may incur as a result of my voluntary services except those damages caused by the sole negligence or willful misconduct of North Whidbey Pool, Park, and Recreation District employees. I understand that, but for this release of any all liability, the District would not accept my offer of volunteering service. I HAVE READ AND VOLUNTARILY SIGN THIS AGREEMENT AND RELEASE OF LIABILITY.*

I agree with the statement aboveI disagree with the statement aboveI am the parent/legal guardian of the applicant and I agree with the statement aboveI am the parent/legal guardian of the applicant and I disagree with the statement above

By entering my name and clicking the "send" button below I certify the above statements to be true and correct to the best of my knowledge.

Signature