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Redmond Senior Center Volunteer Application Redmond Senior Center 8703 160th Ave NE Redmond, WA 98052 ---PAGE BREAK--- Hello Prospective Volunteer, Thank you for your interest in becoming a volunteer at the Redmond Senior Center. We rely on our volunteers to help provide support to our participants and community. We are so grateful for your willingness to be part of our volunteer team! Each volunteer applicant must submit to a background check. We require your name, email and phone number to start this process. You will receive a link to the Dataquest LLC website which will bring you to a secure online form that must be completed. We will be notified when your background check is completed and will contact you about your eligibility, what days/times you’d like to work and when you can start. Please let us know if you have any questions about this screening process. Please contact Sara Bouwman, Volunteer Coordinator, at [PHONE REDACTED] or by email [EMAIL REDACTED]. Name: Phone: Email: Alt Phone: Please take a minute to let us know which volunteer tasks you are most interested in supporting. Please also let us know your availability and duration of service. Location: Redmond Senior Center 8703 160th Ave NE I Redmond, WA 90852 I [PHONE REDACTED] Areas of Interest Senior Center: Front Desk (answer phones; help customers) Meals on Wheels (delivery/packing) Greeter Desk (greet participants; provide info) India Lunch Dining Room (set tables; serve; clear tables) Lunch Ticket Sales Beverage Bar (make coffee, serve) Interest Group Lead: (please write area of interest) Availability: What days, times and frequency would you like to volunteer? Please circle all that apply Mon am or pm Tues am or pm Wed am or pm Thurs am or pm Fri am or pm Sat am or pm Sun am or pm Occasional Events (India Lunch, Special Events) Please indicate how often you’d like to volunteer: (The Senior Center prefers a commitment of once a week for at least a 3-6 months, if possible. Thank you!) I can commit to once a week for 3-6 months or more: I can commit to one to two time a month for 3-6 months or more: I can commit to be a substitute ---PAGE BREAK--- 1 of 2 CITY OF REDMOND VOLUNTEER ACKNOWLEDGEMENT, WAIVER AND RELEASE This form must be completed prior to the start of volunteer activity I ACKNOWLEDGE and UNDERSTAND that I am volunteering my services to the [PARKS- RECREATION DEPARTMENT] gratuitously, without any express or implied promise by the City of Redmond, or the Redmond [RECREATION DIVISION] to compensate me for my services. I ACKNOWLEDGE and UNDERSTAND that I am not an employee of the City of Redmond or the [RECREATION DIVISION] and that I may not represent myself as anything other than a volunteer. I ACKNOWLEDGE and UNDERSTAND that I may be exposed to confidential information while participating in the program and I agree to respect the confidential nature of all information I may come in contact with. I also agree to not remove such information via copies or by recorded means from the Redmond [RECREATION DIVISION]. I will abide by all applicable federal, state and local laws, as well as, the policies and procedures of the City of Redmond and the Redmond [RECREATION DIVISION]. I assume the risks of property damage, injury, or death associated with my volunteer participation. Volunteers working within the scope of their assignment and on behalf of the city have limited medical coverage. I understand that I am to report any on-the-job injury or illness, no matter how minor, to the Volunteer Coordinator. The city does not provide coverage for damage to or loss of personal property. On behalf of myself, my heirs, executors, administrators and assigns, I hereby agree to hold the City of Redmond, its officials, employees, insurers, and other associated parties harmless from all claims arising out of, or in any way connected to, my volunteer duties. I understand that I or the City may terminate this agreement at any time without cause, and that I am volunteering my services at will and may be asked to discontinue such without prior notice or reason. I authorize the use of photographs and/or videotapes of myself, my child/children/ward as part of the City of Redmond Washington promotions. This agreement will be in effect for the duration of my volunteer services, beginning this date: Volunteer Signature: Parent/Guardian Signature (if volunteer is under 18): (Optional Information) Printed name of Signatory: ---PAGE BREAK--- 2 of 2 Home Address: Name: Volunteer Volunteer Name: Phone: Day: Phone: Home: Work or Cell: Email address: In case of emergency, please contact: