Please complete this application form if you are interested in becoming a Naperville Park District volunteer. Once you complete the form, click the submit button at the bottom. Please note that a parent/guardian MUST read the waiver and check the signature box.

Student Volunteer Name and Address

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Cell phone:

* OK to call me here

Email address:

Date of birth:

School:

Parent/Guardian Name and Address

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Cell phone:

Email address:

Relationship:

Availability

Please indicate the days and times you are usually available to volunteer.

Parent/Guardian Informed Consent and Signature Box

I offer to volunteer my services to the Naperville Park District ("Park District"), and recognize that I will not be paid in any way. As a volunteer, I recognize and acknowledge that there are certain risks of physical injury associated with volunteering in this activity and I agree to assume the full risk of injury, including death, physical injury, property damage, or any other loss, regardless of severity, which I may sustain as a result of volunteering in these activities. I understand that not all hazards and dangers can be foreseen. Depending on the particular activity, certain risks, dangers and injuries due to inclement weather, slipping, falling, carelessness, horseplay, premises defects, inadequate or defective equipment, exposure to communicable disease, and other circumstances inherent to recreational activities exist. In consideration of the Park District allowing me to volunteer, I knowingly, freely and voluntarily release, remise, and discharge the Park District, its officers, agents, representatives, employees, volunteers, and independent contractors from any and all liability claims, causes of action, and damages from any personal injury including death, personal loss or damages, or property loss or damage claims I may have or that may accrue to me as a result of volunteering in this activity. In the event that volunteering in this activity requires certain physical acts, I am capable of performing those acts and have not notified the Park District or the other individuals released herein of any reason why I should not be able to perform those physical acts.

Additionally, I hereby give consent for the Park District to use photos or video coverage of me and/or my minor child/ward in future publications and promotions and acknowledge that these photos/videos remain the property of the Park District.

By checking the 'I Agree and So Certify' box below I certify, under oath, that I have never been convicted of a child sex offense or found to e a child sex offender. I also acknowledge that I have read the Volunteer Handbook located at this address

http://www.napervilleparks.org/docs/volunteerhandbook.pdf

I Agree