DRBIPA Volunteer Park Ambassador Enrollment Form
Thank you for signing up to be a DRBIPA Park Ambassador! Be sure to review the Volunteer Handbook on our website at www.drbipa.org/volunteer before signing up as a member of the volunteer team. If you have any questions about volunteer roles or the park association please contact our Volunteer Coordinator, Roxci Bevis, at outreach@drbipa.org.
Name
*
First Name
Last Name
Pronouns (optional)
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Birthday
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you find out about DRBIPA?
*
Why do you want to be a Park Ambassador?
*
Which Park Ambassador committee(s) interest you?
*
Community Outreach & Events
Environment Stewardship & Conservation
Public Education & Communications
Fundraising & Development
What days and times are you usually available? Please check all that apply.
*
Weekdays
Weekends
Morning
Afternoon
Evening
Please provide an emergency contact name and phone number.
*
In the rare case of a medical emergency while volunteering we need to know who to contact for you.
I have reviewed and understand the DRBIPA Volunteer Handbook (found on the website volunteer page) and agree to adhere to DRBIPA mission, vision, values, and policies while volunteering.
*
Yes
I understand that due to the outdoor nature of conservation and stewardship volunteer projects there is a level of risk. Should anything happen to me, or my personal vehicle or equipment, while I am volunteering, I will not hold DRBIPA or any other project partner liable. I am voluntarily taking part in park association activities with knowledge of the risk involved and I agree to accept all risks of participation.
*
Yes
I know that it is my sole responsibility to understand my abilities and only accept volunteer assignments within my skill level and physical limitations. I understand I can ask for accommodations as needed and can take breaks during volunteer activities as needed.
*
Yes
I consent to receive communications from Derby Reach Brae Island Parks Association regularly via email or newsletter, and occasionally by phone or mail.
*
Yes
I commit to prompt attendance at scheduled events and performing assigned volunteer duties to the best of my ability.
*
Yes
I give permission for DRBIPA to use approved photo and/or video of me volunteering with the park association for promotional purposes.
*
Yes
Volunteer Park Ambassador Signature
*
If you are 13 - 15 years of age please provide your guardian NAME and PHONE # here and have them sign below. Volunteers must be 16 to volunteer alone but 13-15 to volunteer with guardian consent; volunteers under 13 must be accompanied by a guardian.
Guardian Signature
Submit
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