Full Text
CITY OF FONTANA VOLUNTEER APPLICATION AREA IN WHICH YOU REQUEST TO PERFORM VOLUNTEER AVAILABILITY: (Hours per Week) of Week) PERSONAL INFORMATION TELEPHONE/CELL DATE OF BIRTH: DRIVER’S LICENSE NUMBER: EMERGENCY ADDRESS & PERTINENT SKILLS ____TYPING/WPM ___FILING ___COMPUTERS __RESEARCH __WRITING __OTHER (explain) EDUCATION/EXPERIENCE HIGH SCHOOL GRADUATE OR EQUIVALENT: ___YES COLLEGE GRADUATE/CURRENT ENROLLMENT: ____YES LAST SCHOOL/COLLEGE ATTENDED: EXPERIENCE: (PAID AND/OR VOLUNTEER): COMPANY/ORGANIZATION DATES OF EMPLOYMENT SUPERVISOR REFERENCES (DO NOT LIST RELATIVES) ---PAGE BREAK--- GENERAL RELEASE OF LIABILITY: For and in consideration of the granting of permission to participate in the activities conducted by and/or with City personnel, in my volunteer status, the undersigned, on behalf of him/herself, his/her heirs, executors, administrators, and assigns, hereby fully releases and discharges City of Fontana, its members, agents, and employees from any and all claims, actions and liabilities that may arise as a result of my volunteer participation with the City of Fontana. The undersigned has read this General Release of Liability and fully understands and acknowledges the significance of said General Release of Liability and hereby assumes full responsibility for any injuries, damages or losses that he/she may incur from my volunteer participation with the City. As a Volunteer, I understand that I will be at-will and that my services may be terminated without cause, at any time, at the sole discretion of the City of Fontana. I also understand that I am not entitled to receive compensation or benefits of any kind from the City, including those afforded in accordance with CA Workers’ Compensation laws. I am also aware that I have no expectation of future employment with the City of Fontana I further understand that should I use my automobile in Volunteer Service, I will keep in effect, automobile liability insurance equal at least to the minimum limits required by the State of California. REVIEW CAREFULLY BEFORE SIGNING DATED: Printed Name of Participant Signature Signature of Parent or Guardian (if a minor) Application must be returned to the Human Resources Department for processing HR Review and Comments: