Transcript Document

Required If Under 18 Years of Age
I certify that my son/daughter is fully capable of participating as a volunteer for the City
of Newark and has my permission to be assigned. I have also read and understand the
volunteer policy listed below.
Signature of Parent or guardian ___________________________ Date ______________
IMPORTANT: VOLUNTEER POLICY Make sure you have read and understand the following:
City of Newark
Parks & Recreation Department
Volunteer Application
• I understand the risks involved in being a volunteer for Newark Parks and Recreation and that
transportation to and from the project site may be provided on park work vehicles run by park
employees who are fully trained to operate such equipment. I understand that neither the City of
Newark, nor Newark Parks and Recreation, nor any city employee, will assume any financial liability for
any injury or illness that I, or any family member or friend might incur while performing voluntary
service for Newark Parks and Recreation.
• Volunteers agree to perform service without compensation and are not considered employees of
the City of Newark. Newark Parks and Recreation does not provide Worker’s Compensation or any
other insurance coverage for volunteers.
• Volunteers agree to adhere to Parks and Recreation rules and procedures. Furthermore, volunteers
agree not to attempt work that is beyond their abilities or for which the volunteer has not been
assigned, trained, or authorized.
• Newark Parks and Recreation cannot guarantee volunteer placement. The City will, however, make
every effort to match volunteer applicants to volunteer opportunities based on the needs of Newark
Parks and Recreation and the interests and abilities of the volunteer.
• Newark Parks and Recreation accepts the service of all volunteers with the understanding that such
service is at the sole discretion of the City. Volunteers agree that the Newark Parks and Recreation
Department and the volunteer may at any time, for any reason, decide to terminate the volunteer’s
relationship with the City. Notice of such a decision should be communicated as soon as possible to
the volunteers supervisor.
_______________________________________________
(Signature of Volunteer)
Emergency Release Waiver
Ways To Apply
Mail
City of Newark
Parks & Recreation Department
220 South Main Street
Newark, DE 19711
Walk In
(Monday - Friday 8:30am - 5pm)
City of Newark Municipal Building
Parks & Recreation Department
220 South Main Street
Newark, DE 19711
Fax
(302) 366-7169
Online
www.cityofnewarkde.us/parksrecreation
______________________
(Date)
The undersigned, as parent/guardian of __________________
hereby authorize the City of Newark, Department of Parks & Recreation and
the Newark Medical Center to provide and render necessary medical care
and treatment of the aforesaid child of any illness or injury, which child may
suffer at any time while in their custody. It is understood that time
permitting, specific permission of the parent/guardian will be secured in the
event of any medical treatment or surgery is to be undertaken, but that,
should an emergency arise, this authorization and consent will cover such
event. Also, I(we) hereby accept responsibility for any accident which may
occur in connection with this activity, hold harmless the City of Newark, and
all other parties involved in the promotion and/or conducting of the above
named activity. As well, I (we) understand that the City of Newark provides
NO medical insurance coverage or workers compensation for this volunteer
activity. I give permission for myself and/or my child to be photographed
while participating and/or attending a Parks and Recreation activity. I
understand that photos may be used in future publicity.
Signature of Applicant or Parent/Guardian if under 18
Date
For additional information, please call (302) 366-7000
Email Chrissy Palmer at [email protected]
Visit us online at www.cityofnewarkde.us/parksrecreation
City of Newark
Parks & Recreation Department
Volunteer Application
Name _________________________________________________________
Address _______________________________________________________
City _______________________ State _______________ Zip Code _______
Birthdate Month ____________ Day _____________ Year _____________
Phone
Home _______________ Work ______________ Cell _________
Emergency Contact Information
1. Name ___________________________ Phone Number ________________
Relationship _________________ Alternate Phone Number _______________
2. Name ___________________________ Phone Number ________________
Relationship _________________ Alternate Phone Number _______________
Please place an X in the box next to any program(s) that you would be interested in
volunteering for.
Spring
Winter
Are you applying to volunteer in order to fulfill a service requirement? Yes / No
____ Community Clean Up
____ Egg Hunt
____ Memorial Day Parade
____ After School Center
____ Santa’s Secret Shoppe
____ Snack With Santa
____ Basketball Coaching
____ After School Center
If yes, please list the school or organization: ___________________________
Summer
Year Round
____ Liberty Day
____ Safety Town
____ Camp GWC
____ Rittenhouse Camp
____ Specialty Camps
____ Adopt-a-Park
____ Eagle Scout Project
____ Park Litter Pick Up
____ Park & Trail Maintenance
Fall
Other
Email Address ___________________________________________________
If you are a college student or graduate, please list your major: ____________
Skills, interests or hobbies: ________________________________________
Please indicate your availability (days, seasons, hours, etc.) ______________
______________________________________________________________
Have you ever been convicted of a felony or class A misdemeanor? Yes / No
If yes, please explain: ___________________________________________
_____________________________________________________________
Do you have any physical or medical limitations, which may interfere with your
ability to carry out certain assignments: Y / N
If yes, please explain: ___________________________________________
____ Newark Community Day
____ Fall Community Clean Up
____ Turkey Trot 5K/10K Run
____ Halloween Parade
____ Halloween Party at GWC
____ Soccer Coaching
____ After School Center
___________________________
___________________________
___________________________
___________________________
Thanks for your interest in volunteering with the
City of Newark Parks and Recreation!
After receiving your application, a recreation specialist will contact you with additional
information regarding your volunteerism. Some programs may require background checks
and/or additional information.