Volunteer Application Form

Name *

First

Last

Email *

Email

Confirm Email

Phone Number *

Mailing Address *

City *

State *

Zip Code *

Please select all events you are interested in helping with: *

• Volunteer Recognition Night
• City Wide Garage Sale Weekend
• City Wide Clean-Up Day
• Strawberry Shortcake Feast
• Ice Cream Social
• Elephant Garlic Festival
• Chili Cook-Off
• Holiday Gift Bazaar
• Jingle thru North Plains
• Other

When are you available? Please indicate all available hours: *

• Mornings
• Afternoons
• Evenings

Please describe any special skills or training you have: *

Are you a licensed driver? *

• Yes
• No

Are you aged 16 or over? *

• Yes
• No

Do you have cash register experience? *

• Yes
• No

Emergency contact information - Name *

Emergency contact information - Phone Number *

Emergency contact information - Relationship *

Do you have any medical limitations that the event supervisor should be aware of? *

STATEMENTS and DISCLAIMERS: I further assume all risks of personal injury, death and property damage resulting from providing these volunteer services to the City of North Plains and its agents. I release the City of North Plains and the North Plains Events Association and their agents from any liability to me for personal injury, death or property damage arising out of these volunteer services. I agree to work without any monetary compensation and without worker's compensation coverage while volunteering. The City of North Plains and its agents are not responsible for lost or stolen items during any event. I hereby grant the City of North Plains the right to use forever any photographs, video or audio taken during the volunteer activity for inclusion in any promotional or advertising purposes in print, electronic or other media without my notification and I agree to appear without pay. *

• I agree to the above statements and disclaimers.

Signature *

Date *

Phone

Submit

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