Student Volunteer Interest Form

Contact Information

First Name *

Last Name *

Date of BIrth * +

Preferred Name

**If the student is a minor, a parent/guardian must sign constent. However, the CCI participant is responsible for communicating schedule, hours, and any absences to the supervisor.

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

School Information

School Name: *

Year in School *

+-

Availability and Program Interest

Program Interest *

Please list dates and times you are available below. *

Parent/Guardian Contact Information

First Name *

Last Name *

Relationship to Volunteer *

Phone Number *

Email Address *

Parent/Guardian Consent

My minor child offers to volunteer their services to the Oswegoland Park District ("Park District"), and recognizes that they will not be paid in any way. As a volunteer, my minor child recognizes and acknowledges that there are certain risks of physical injury associated with volunteering in this activity and they agree to assume the full risk of injury, including death, physical injury, property damage, or any other loss, regardless of severity, which they may sustain as a result of volunteering in these activities. They 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 my minor child 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 my minor child and/or I may have or that may accrue as a result of volunteering in this activity. In the event that volunteering in this activity requires certain physical acts, my minor child is capable of performing those acts and have not notified the Park District or the other individuals released herein of any reason why they 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 signing below I certify, under oath, that I have never been convicted of a child sex offense or found to be a child sex offender.

I consent for my child to volunteer for the Oswegoland Park District. *

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Date * +