Gesa Carousel of Dreams Volunteer Form

Carousel of Dreams Foundation Volunteer Application and Agreement Form
Date

MonthDayYear
Full Name

First NameLast Name
*If volunteer is under 18 years, the parent or guardian must also complete a volunteer application and agreement form.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Company or Volunteer Group Name
Date of Birth

MonthDayYear
Drivers License Number
Emergency Name

First NameLast Name
Emergency Relationship
Emergency Contact Phone Number
Emergency Phone Number. Indicate home, work or cell.
Do you have friends/family members who work here?

YesNo
Types of volunteer work you'd be most comfortable with

MarketingConstructionOperationsConcessionsOther
BACKGROUND CHECK: Carousel of Dreams and its entities requires that all volunteers and employees submit to a background check. No employee, agent or volunteer who has been convicted of a violent crime or crime of moral turpitude shall assist or participate in any manner with the Carousel operations or maintenance. Violent crimes include, but are not limited to, homicide, rape, child molestation, felony assault, robbery, kidnapping, stalking, assault domestic violence, or assault with sexual motivation. Details of the offense will be taken into consideration before a decision is made. There is no fee on the part of the volunteer for the background check. Screening must be completed before volunteers begin working with consumers.
I agree to have a background check*

Yes
As a volunteer for Carousel of Dreams, I agree to abide by all applicable rules and regulations of the agency and Washington State law. I may terminate this agreement at any time without prior notice for any reason. I hereby authorize to Carousel of Dreams to check my references, and I understand that a criminal background check is required.

I certify that my answers on this application are true and complete and that I have not knowingly withheld any information that might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application could be cause for rejection of this application or dismissal.

I understand that after I submit my application, it will be reviewed and my eligibility for volunteer work will be determined. I agree to an interview with the on-site manager and on site orientation to perform my volunteer role.

I hereby Release and Waive liability against Carousel of Dreams, a non-profit corporation, its directors, officers, employees and agents, its successors and assigns, for any injuries or illness that I myself or my dependent may suffer in connection with any volunteer work for Carousel of Dreams. Further, I agree that Carousel of Dreams is not liable for any damage to my property or my dependent’s property resulting from volunteer work for them. I agree that this release is as broad and inclusive as permitted by the laws of the Washington.
Volunteer Signature
Date Signed

MonthDayYear
Should be Empty:

Carousel of Dreams Foundation Volunteer Application and Agreement Form