Single Activity Waiver for Non-Registered Volunteers

Single Activity Waiver for Non-Registered Volunteers

This form allows an individual to volunteer for a specific activity, including programs, events, workdays, or other opportunities, with the permission of the site steward or District staff. A parent or legal guardian's electronic signature is required for volunteers under age 18.
Activity or Event*
If you answered "Other" to the previous question, please provide a brief description in the field below.
Site
Location where you will volunteer
Volunteer Leader or Staff Liaison
Volunteer Information
First Name*
Last Name*
Are you 18 years of age or older?*

YesNo
Date of Birth*

MonthDayYear
Street Address*
City*
Zip Code*
Phone*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact
Name*

First NameLast Name
Relationship to Volunteer*
Phone*
Please enter a valid phone number.
Cell/Alternate Phone*
Please enter a valid phone number.
Medical Conditions
List any medical conditions, allergies or concerns which District staff should be made aware:
Please read and complete the following fields carefully.
I understand and agree that in volunteering for the Wheaton Park District that I (or any minor child/ward) am engaging in volunteer work and will not receive compensation for any service provided by me. I agree to follow the directives of the activity leader and work cooperatively with fellow volunteers. I recognize and acknowledge that there are certain risks of physical injury to volunteers, and I voluntarily agree to assume the full risk of any and all injuries, damages, or losses, regardless of severity, that I or my minor child/ward may sustain as a result of these volunteer services. I understand that as a volunteer, I (or my minor child/ward) will not be entitled to benefits normally associated with employment, such as workers’ compensation insurance and unemployment insurance. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in volunteer services for the District, including its officials, agents, volunteers, and employees.

The District holds the safety of volunteers in high regard and is committed to conducting its programming and activities in a safe manner. The District continually strives to reduce risks and requires that all volunteers follow safety rules and instructions designed to protect the volunteer’s safety. I understand that it is my (or my minor child’s) responsibility to wear all required personal protection equipment during volunteer activities as directed by the project leader. Any volunteer who engages in unsafe activities or refuses to follow the District’s behavior code of conduct and safety policies/procedures will be asked to leave.
The District is required by state statute (70 ILCS 1205/8-23a) to ask if you have ever been convicted of or found to be a child sex offender?*

YesNo
In order to participate in the activity as a volunteer for the District, you must agree that you have read, fully understand, and agree to the above waiver and release of all claims and have answered all questions truthfully.*

I agree
Signatures entered into the fields below will have the same legal effect as an original form signature.
Volunteer's Name

First NameLast Name
Volunteer's Signature

Clear
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature

Clear
If a signature is not included in this form submission, participation will be denied.
Should be Empty:

Single Activity Waiver for Non-Registered Volunteers

Volunteer Information

Emergency Contact

Medical Conditions

Please read and complete the following fields carefully.