Waiver:
I understand the City of Gainesville (“City”), to protect its citizens, will make the appropriate inquiries into my background as prescribed by Florida Statute 943.04351, and will conduct a routine check of my name through law enforcement agencies and license bureaus, and hereby authorize the City to do so. I understand that a criminal offense will not automatically exclude me from all chaperone, coach, intern and volunteer positions; however, certain convictions will exclude me from volunteering in some positions. Accordingly, I authorize those parties contacted by the City to conduct the check and to cooperate by releasing information as requested to the City, and in signing this document I release the City, its officers, employees, staff, and agents from any damages or liability that may result from said background check. I sign this Application and release of my own free will and accord, with full knowledge of the purpose therefor.
For a summary of your rights under the Fair Credit Reporting Act, see www.consumer.ftc.gov/articles/pdf-0096-fair- credit-reporting-act.pdf, or request a copy from the City of Gainesville’s Department of Parks, Recreation & Cultural Affairs at (352) 393-8335.
Declaration: As an applicant for Coach/Intern/Volunteer in a positive position of trust for the City, I hereby attest that I am of good moral character and that I have not plead “Guilty” or “Nolo Contendere” to, or been found guilty by a jury or a court, of (1) any felony; (2) a sex offense; (3) a misdemeanor involving physical violence, theft, driving under the influence of alcohol or drugs, or possession or sale of drugs; or (4) have been found to have committed a delinquent act as defined in Florida Statute 985.03(53); regardless of whether or not adjudication has been withheld and/or probation imposed, regarding an offense of a type listed in (1)-(4), above. I further attest that I have not been judicially determined to have committed abuse against a child as defined in Florida Statutes, or to have a substantiated, indicated report of abuse as defined in Chapter 415, Florida Statutes, or to have committed an act, which constitutes domestic violence as defined in Section 741.28, Florida Statutes.
I hereby indemnify the City of Gainesville, its officials, agents and employees, and hold it harmless from all suits, actions, damages, liability and expense for injury or damage claimed to be associated with my activities as a Coach/ Intern/Volunteer for the City and that occur or are committed by me while acting outside the course and scope of my duties and functions as a Coach/Intern/Volunteer or committed in bad faith, with malicious purpose, or in a manner exhibiting wanton and willful disregard of human rights, safety, or property.
I hereby give my consent to the City to secure and authorize such emergency medical treatment as I might require while performing my duties. I also agree to pay all the costs and fees contingent on emergency medical care or treatment as secured or authorized under this consent. I further release all officials and professional personnel from any claim whatsoever on account of first aid treatment or services rendered to me during my participation as a Coach, Intern, or Volunteer for the City.
I understand that as a Coach/Intern/Volunteer, I am covered under the Workers’ Compensation Law in Florida Statutes Chapter 440 for injuries I may sustain within the scope of my duties. I agree to perform my duties as directed by the City of Gainesville’s Department of Parks, Recreation & Cultural Affairs and to follow City and Department policies and procedures. Further, I agree to accept the coverage of the Workers’ Compensation as the sole remedy for any damages I suffer from any and all services performed for the City, and agree not to seek any damages not covered by the Workers’ Compensation Law, in exchange for being provided this coverage.
I understand that the Coach/Intern/Volunteer programs offered by the City of Gainesville’s Department of Parks, Recreation & Cultural Affairs do not provide compensation, except as otherwise provided by law, and that service will not confer on me the status of a City employee. I acknowledge that my participation is completely voluntary, and that I can be released for any reason without notice and would not be entitled to any recourse. I also understand that, regardless of my previous appointments as a volunteer, the City of Gainesville is not obliged to appoint me to a volunteer position.
I do herby grant full permission to the City to make and use photographs or video recordings of myself during my participation as Coach/Intern/Volunteer, for any publication, broadcast medium, or display, voluntarily and with the understanding there is no remuneration for such use.
This Volunteer Services Application contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. The provisions of this agreement are severable, if any portion of the agreement is held to be invalid, the remainder shall continue in full legal force and effect.
If the Applicant is a minor, the undersigned parent or legal guardian warrants and represents that this Application, and the liability waivers, indemnifications, authorizations, and other provisions have been explained to and understood by the minor child, are understood by the undersigned parent or legal guardian, and that this Application has been signed freely and voluntarily and without any inducement or assurance of any nature.