Please complete this application form if you are interested in becoming a Fire District volunteer. Once you complete the form, click the submit button at the bottom.

*** BEFORE FILLING OUT THE INFORMATION BELOW, PLEASE NOTE THE FOLLOWING:

1. Please be advised that all Fire District volunteers MUST be fingerprinted by the Rancho Cucamonga Police Department and Administrative Services AND CLEARED with the Department of Justice BEFORE BEGINNING volunteer service (no cost to volunteer).

2. The Fire District does not have volunteer fire fighter opportunities.

3. The Fire District is unable to accept COURT ORDERED VOLUNTEERS. If you are trying to fulfill Court mandated hours, please contact the Inland Valley Resource Center at (909) 623-1284(This agency is not affiliated with the City of Rancho Cucamonga).

4. Applicants interested in volunteering for the Fire District's Fire Corps program MUST be 18 years or older, with the exception of Fire Explorers who must be 15- to 21-years-old per Learning for Life (parent organization).

5. Applicants interested in volunteering for the Fire District's ReadyRC program (Large Animal Response Team, Auxiliary Communication Service, and Advanced CERT) must be age 16 or older. For Advanced CERT, proof of completion of Basic CERT training is a pre-requisite.

6. Upon Livescan (fingerprinting) clearance, all applicants must attend a mandatory orientation, including signature of acknowledgement of Fire District volunteer manual PRIOR to registering for Fire District assignments.

7. Volunteer opportunities are limited to ensure a well-balanced and efficient program that does not exceed a manageable coordinator-to-volunteer ratio.

8. To best serve the needs of the community and to help resume programming and services, the City of Rancho Cucamonga has implemented a vaccination policy for all volunteers. Effective April 13, 2021, all City volunteers will now be required to have the COVID-19 vaccination(s) to resume volunteering with the City of Rancho Cucamonga. In accordance with the City of Rancho Cucamonga's responsibility to provide and maintain a safe community, the City adopted the Pandemic City Policy for Volunteers to safeguard the health of our volunteers, employees, our customers and visitors and their families from infectious diseases that may be reduced by vaccinations.

To continue the application process, please complete the information below. Items indicated with an asterisk(*) are required. Once you complete the form, click on the "I AGREE" check box(agreeing to the Release information and Volunteer Service Agreement at the end of this document) and the "CONTINUE" button at the end of this form in order to submit your application.

Name and address

First name:

Last name:

Title:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Email address:

Additional Information

Information below indicated with an asterisk(*) is required. All other information is optional; however, it allows us to develop a better understanding of the demographic make-up of our volunteers.

Your Age Group:

Date of birth:

Age:

Gender:

Education:

Are you a court ordered volunteer?:

Emergency Contact Information

For use in the event of an emergency, please supply the names and phone numbers of two individuals whom we may contact.

1

2

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Skills & Training

Interest

Please inform us of any special interests you may have for volunteering:

References

Please list two non-family references whom we might contact:

* Assignment Preference:

Fire District

1

2

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Release

Fingerprinting is required for all Fire District volunteers per Section 5164 of the Public Resources Code. The Fire District staff coordinates fingerprinting requirements with the City's Personnel Department. A Live Scan fingerprinting process is initiated and funded by the Fire District, and administred by the City's Police Department, Fire District and the California Department of Justice(DOJ). The DOJ determines a volunteer applicant's status of eligibility. Confidential background reports are then communicated to the Fire District by DOJ and must be handled in accordance with the State Privacy Act.

Volunteer Service Agreement

I agree to become a volunteer with the Rancho Cucamonga Fire District. During the time that I am serving as a volunteer I agree to adhere to the following:
1. Follow the Rancho Cucamonga Fire District's Mission Statement and Core Values.
2. Comply with all policies, procedures, rules, regulations, directives and instructions provided.
3. Maintain a positive attitude and work to the best of my ability.
4. Be professional and courteous when providing programs or services to the public.
5. Remain dedicated to maintaining a high level of physical, mental and emotional fitness.
6. Be safe and be smart.
7. Maintain Fire District equipment and facilities.
8. Be an effective team member who is adaptable to change.
9. Continue to grow both professionally and personally.
10. I will assist all Fire District and Public Safety members to the best of my ability.

In return, the Fire District will provide me with an orientation and training that will give me an overview of the Fire District in order to provide excellent customer service. I understand that I will not be allowed to work directly with the public until I have completed this training.

I hereby grant permission to be photographed and/or video while participating in Fire District activities and/or to have any such work incorporating my image or original work I produce in conjunction with the activity to be published in association with the Fire District's promotional and/or educational activities. I waive any right to compensation for such photographs, videotapes, images and/or original work for the use of publication thereof.

I HAVE READ THE FOREGOING AND ACKNOWLEDGE THAT I AM GIVING UP IMPORTANT LEGAL RIGHTS BY SIGNING THIS AGREEMENT.
I agree to these terms under penalty of perjury.

First name:

Last name:

Volunteer Information Center

We provide an online "Volunteer Information Center" where volunteers may check their schedules, update their information, and recieve messages. Please select the password you would like to use to access the online Volunteer Information Center(password must be a combination of at least 6 letters and numbers).

If your application is approved, you will be notified and invited to participate in an interview. Fire District volunteers may access information by logging onto our website:

www.rcfire.org

COVID-19 HEALTH WAIVER

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health
Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person
contact. As a result, federal, state, and local governments and federal and state health agencies recommend
social distancing and have, in many locations, prohibited the congregation of groups of people.
While COVID-19 can cause mild symptoms in some individuals, it can lead to severe illness and even death in
others. Adults over age 65 and people of any age with serious underlying medical conditions including, but not
limited to, HIV, asthma and other respiratory conditions, and pregnancy, may be a higher risk for more serious
complications from COVID-19.
The City of Rancho Cucamonga has put in place preventative measures to reduce the spread of COVID-19;
however, the City cannot guarantee that you will not become infected with COVID-19. Further, participating in
City volunteer activities and interacting with City staff and members of the public could increase your risk of
contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I and/or my
child(ren) may be exposed to or infected by COVID-19 by participating in an activity with the City of Rancho Cucamonga
or attending as a spectator and that such exposure or infection may result in personal injury, illness, permanent disability,
and death. I understand that the risk of becoming exposed to or infected by COVID-19 by participating in City programs
may result from the actions, omissions, or negligence of myself and others, including, but not limited to, City employees,
third party contractors, volunteers, program participants and the general public.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and/or my
child(ren) (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or
expense, of any kind, that I and/or my child(ren) may experience or incur in connection with my and/or my child(ren)’s
participation in City programs. On my behalf, and/or on behalf of my child(ren) I hereby release, covenant not to sue,
discharge, and hold harmless the City, its employees, agents, and representatives, of and from the Claims, including all
liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and
agree that this release includes any Claims based on the actions, omissions, or negligence of the City, its employees,
agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any City
program.
I agree to these terms under penalty of perjury.

Risk and Waiver of Liability Relating to COVID-19

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

While COVID-19 can cause mild symptoms in some individuals, it can lead to severe illness and even death in others. Adults over age 65 and people of any age with serious underlying medical conditions including, but not limited to, HIV, asthma or other respiratory conditions, and pregnancy, may be at higher risk for more serious complications from COVID-19.

The City of Rancho Cucamonga has put in place preventative measures to reduce the spread of COVID-19; however, the City cannot guarantee that you will not become infected with COVID-19. Participating, volunteering, providing contractor services, and interacting with City staff and members of the public could increase your risk of contracting COVID-19.

By accepting this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I and/or my child(ren) may be exposed to or infected by COVID-19 by participating in an activity with the City of Rancho Cucamonga or attending as a spectator and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID19 by participating in City programs may result from the actions, omissions, or negligence of myself and others, including, but not limited to, City employees, third-party contractors, volunteers, program participants and the general public.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and/or my child(ren) (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I and/or my child(ren) may experience or incur in connection with my and/or my child(ren)’s participation in City programs. On my behalf, and/or on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless the City, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the City, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any City program.

I agree to these terms under penalty of perjury.

I Agree