Thank you for helping with this event. In order to register for this event at Pacific Science Center, all registrants must provide the following information. Please fill out the form below, which includes giving permission for Pacific Science Center to conduct a Washington State Patrol (WSP) criminal history records check, the Pacific Science Center Code of Conduct, and an Appearance Release Form.

Personal Information

Emergency Contact

What event/position are you applying for?

Do you have any allergies that we should know?

Washington State Patrol & U.S. DOJ NSOPW Check

Pacific Science Center prioritizes the safety and well-being of our guests, volunteers, and staff. By registering to volunteer for our upcoming Special Event, you consent to Pacific Science Center conducting a Washington state criminal records check and a National U.S. Department of Justice NSOPW check.

You can learn more about the WSP check by visiting the Washington State Patrol website here:

You can learn more about the U.S. Department of Justice NSOPW check here:

Pacific Science Center will make a determination on a case-by-case basis your eligibility to volunteer based on the results of your records check. A criminal history may not immediately disqualify you from volunteering with Pacific Science Center, but we encourage you to register early because checks can require at least two weeks to make a determination.

By signing and dating below I give the Pacific Science Center permission to verify my eligibility to volunteer through a Washington State Patrol Criminal History Records and U.S. Department of Justice NSOPW check.

Code of Conduct in Dealing with Children

It is the desire of Pacific Science Center (PSC) to provide the highest quality services available to our children (anyone below 18 years of age). Our commitment as an organization is to create an environment for children that is safe, nurturing, empowering and which promotes growth and success for the children who participate in our services. To clarify our vision of how this will be accomplished,

the Code of Conduct outlines specific expectations of staff as we strive to accomplish our mission together.

1. Children will be treated with respect at all times and without regard to their race, color, national origin, sex, age, religion, disability, or other trait protected by applicable law.

2. We will not use inappropriate language or tell off‐color jokes in the presence of children.

3. We will not discuss sexual encounters with children or in any way involve children in our personal problems or issues.

4. We will not use or be under the influence of alcohol while on duty, especially in the presence of children.

5. We will not have sexually oriented materials at work, including printed or internet pornography.

6. We will not have secrets with individual children.

7. We will dress conservatively and appropriately.

8. We will not stare at or comment about a child’s body.

9. We will avoid affectionate behavior with children when there is no other adult present to witness it.

10. We shall not abuse children in any way. Abuse would include any of the following:

-Physical abuse including hitting, spanking, shaking, slapping, or using unnecessary restraints.

-Verbal abuse including degrading, inappropriately threatening, or cursing.

-Sexual abuse including inappropriate touching, exposing oneself, or having sexually oriented conversations.

-Mental abuse including shaming, humiliation, or cruelty.

-Neglect including withholding food, water, or shelter

11. Everyone, including other children, is prohibited from hazing, bullying, derogatory name‐calling, games such

as "truth or dare" or singling out one child for differential treatment, ridicule or humiliation.

12. You must submit in writing any plans for outside contact with any children who are enrolled in PSC programs, with prior written parental permission, by submitting Off‐Hours Contact Form to the highest ranking program supervisor/coordinator, who can be reached at (206) 443‐2001 and to the Human Resources Manager at (206) 269‐2130. This form is available in the Public Folder under HR Dept. – HR Misc.

13. You must report concerns or complaints about abusive behavior by any Pacific Science Center staff member, volunteer or participating child to the highest ranking program supervisor/coordinator, who can be reached at (206) 443‐2001 and to the human resources manager at (206) 443‐2862. Every allegation of abuse will be taken seriously. PSC will cooperate fully with the authorities and comply with all applicable laws.

14. You are required to report suspected abuse by anyone to state authorities by calling 1‐866‐ENDHARM (1‐866‐363‐4276).

15. If you are arrested or charged with any crime against children, including but not limited to child abuse,

indecency with a child, or sexual assault or exploitation of a child, then you must immediately notify PSC's

human resources manager at (206) 443‐2130 so that PSC may review the situation and take those

precautions it deems appropriate.

Pacific Science Center will not tolerate any form of abuse in dealing with children. PSC will take strict disciplinary action against anyone who is found to have committed such abuse. Pacific Science Center will fully cooperate with authorities if allegations of abuse are made and being investigated. Consistent with applicable law, PSC does not accept registrants who have been convicted of any crime against children, including but not limited to child abuse, indecency with a child, or sexual assault or exploitation of a child.

Code of Conduct Acknowledgement

This is to acknowledge that I have received the Code of Conduct in Dealing with Children. I have read the Code of Conduct in Dealing with Children and understand the items discussed. I understand that any violation of this Code of Conduct may result in disciplinary action. I declare that I have not perpetrated physical abuse, sexual abuse, mental abuse, or neglect against a child of vulnerable adult and I have never been convicted of these acts.

Appearance Release

For good and valuable consideration, receipt of which is hereby acknowledged, I authorize Pacific Science Center to make use of my appearance for pictures or programs in connection with marketing Pacific Science Center.

I agree that you may tape and/or photograph me and record my voice, conversation and sounds, including any performance of any musical composition(s), during and in connection with my appearance and that you shall be the exclusive owner of the results and proceeds of such taping, photography and

recording with the right, throughout the world, an unlimited number of times in perpetuity, to copyright, to use and to license others to use, in any manner, all or any portion thereof or of a reproduction thereof to publicize Pacific Science Center. For purposes of clarity, I expressly waive any and all rights I may have in connection with my appearance.

I further agree that you may use and license others to use my name, voice, likeness and any biographical material concerning me which I may provide, in any and all media in the promotion and marketing of Pacific Science Center throughout the world in all media, an unlimited number of times in perpetuity. I further represent that any statements made by me during my appearance are true, to the best of my knowledge, and that neither they nor my appearance will violate or infringe upon the rights of any third



I agree that the information that I provided for the WSP Background Check is correct. I agree that I have received and read the Code of Conduct in Dealing with Children, and the Appearance Release form.