Welcome to the first step of becoming more engaged in your community! In order for us to match you appropriately, please complete the following information. Soon thereafter, a member of our team will be in contact with you.


Name and Address


Personal Information


Employment Information


Skills/Interests/Honors

Please list skills, interests, or honors that will help us make an appropriate volunteer match for you (such as sports, teaching, computer skills, translation abilities, certifications/awards, career exploration interest, etc.)



References

Please list two references OTHER THAN RELATIVES.



Why are you interested in volunteering?

List the reasons why you want to become a volunteer for the City of Dublin, or which projects you're interested in helping out with.



Waiver and Release

I recognize and acknowledge that by volunteering for The City of Dublin in any capacity, there are certain risks involved and I agree to assume all such risks including any damages resulting from physical injuries, death, loss of services or consortium, loss or damage to property, or any other loss which I, my child for whom I am the legal guardian may sustain as a result of participating as a volunteer for the City. As a volunteer for The City of Dublin, I understand that an injury to myself or my child sustained as a result of acting strictly within the agreed upon scope of my/my child’s volunteer duties may be covered under the City of Dublin’s volunteer accident insurance as negotiated by the City year-to-year. Any coverage so provided will be governed by policy language. I also understand that the City of Dublin does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury, illness, death, or property damage. I also certify that I am/my child is in the appropriate physical and mental condition to participate as a volunteer.


I understand that this Agreement is intended to be as broad and inclusive as permitted by the laws of the state of Ohio and that if any portion of this is invalid, the remainder will continue in full legal force and effect. I have carefully read and voluntarily sign this Waiver and Release of all claims and fully agree and understand that its contents and meaning as a full waiver and release of all claims and liability against the City, its elected officials, officers, agents, servants, employees, volunteers and insurers.


Finally, I grant full permission to the City to use any photographs, videos, or recording of myself, my child or minor for whom I am the legal guardian while volunteering for any purpose.


If you are 18 or older, please enter your name to confirm.

If you are a minor, your guardian must enter his/her name to indicate permission for volunteer service.



Emergency Contact


Agreement

I certify that the statements made on this application are true and correct and have been given voluntarily. I understand this information may be disclosed to any party with legal and proper interest, and I release the City of Dublin from any liability whatsoever for supplying such information. I understand that I/my child will not be paid for services as a volunteer. I also understand that completing this application does not necessarily guarantee a position of volunteer service.