Volunteer Application Form
Please complete this application form if you are interested in becoming a volunteer for the Fine Arts Center at Viterbo University. Once you complete the form, click the submit button at the bottom.
Contact Information
First name:
*
Last name:
*
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip:
*
Home phone:
*
OK to call me here
Work phone:
OK to call me here
Cell phone:
OK to call me here
Email address:
*
Emergency Contact
First name:
*
Last name:
*
Street 1:
City:
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Home phone:
*
OK to call here
Work phone:
OK to call here
Cell phone:
OK to call here
Relationship:
Choose
Child
Co-worker
Friend
Neighbor
Other
Parent
Sibling
Spouse
Supervisor
*
Password
Please enter a password that you will use to access signup sheets, review your assignments, and change your profile if needed.
Please enter a password that:
Is between 8 and 30 characters long
Contains both letters and numbers.
Contains a combination of both uppercase and lower case letters.
Password:
*
Confirm password:
*
Job Assignment Preference
If you prefer to do a specific job or have a location preference, please list that here.
Job Assignment Preference:
Electronic Signature*
Read the following statement and "sign" here as well as check the "I agree" box below.
Viterbo Volunteer Liability Release Statement
Viterbo University Volunteer Liability Release Statement
In consideration of being permitted to volunteer for Viterbo University (the “University”), I,acknowledge and fully understand that I will be engaging in activities that involve risks, including but not limited to the risk of injury or death resulting not only from my actions, inaction, or negligence, but the actions, inaction, or negligence of others. These risks include but are not limited to travel to and from the site, equipment used at the site, conditions that exist on the premises, and other risks that may not be known to me or are not reasonably foreseeable.
I voluntarily assume all risk of loss, damage, illness, injury or death that I may sustain while participating in any University-sponsored activities. On behalf of myself and my heirs and estate, I agree to release, waive, discharge, and hold harmless Viterbo University, and their respective officers, officials, agents, volunteers, and employees from any and all claims, demands, liabilities, loss, or damages resulting from my participation in the University’s volunteer program, except as may be caused by the gross negligence or willful misconduct of the University or its employees and agents.
I do further give my consent and permission for, and waive and/or assign any and all rights to any photographs or videotapes taken by the Center or the University while the above activities are in progress. As exclusive owner of such photographs and/or videotapes, the University shall have the sole and exclusive right to display and/or reproduce these photographs and videos, and any copies made.
The University reserves the right to decline to accept or retain me in the program at any time should my actions or general behavior impede the operation of the program or the rights or welfare of any person. Similarly, if my conduct violates any policy or procedure of the University, I understand that I may be required to leave the program at the sole discretion of the University’s representatives and agents, and may be referred to the appropriate University officials for further disciplinary or other action.
I have read and do fully understand and agree to abide by the Viterbo University Liability Release Statement as written above.
I Agree
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