A group of adults standing in a green open area wearing winter gear.

Centerville-Washington Park District Adult Volunteer Application

Answers to the application questions will be utilized for applicable, job-related information only and will not be released to any other organization or volunteers without your consent.

By submitting your volunteer application, you agree to the following:

I certify that the statements contained herein are true to the best of my knowledge. I understand that falsification of any answers or any failure to answer any question contained herein is cause for dismissal from volunteering with the Centerville-Washington Park District. The Centerville-Washington Park District has the right to refuse volunteer service at their discretion.

I acknowledge that I am volunteering to assist the Centerville-Washington Park District and understand that as a volunteer I will not be compensated for my donated services. I am not eligible for any workers’ compensation benefits and I am not covered by any medical insurance in the event that I become injured while volunteering and the Centerville-Washington Park District cannot be held liable. I understand and agree that the Park District may make a thorough investigation of my past and current employment and activities (including but not limited to motor vehicle operator and police record investigation) and I release from liability or responsibility all persons or organizations supplying such information. All information is subject to verification.

I agree to abide by the rules and regulations of the Centerville-Washington Park District.

In consideration of your accepting my entry, I hereby, release, indemnify, and hold harmless the Centerville-Washington Park District, its Commissioners, Agents, Employees and Assignees from any and all liability claims, actions, demands and judgments arising out of injury or loss sustained by me while participating in activities or using facilities of the Centerville-Washington Park District.

Adult Volunteer Application

Fields marked with an * are required.

Full name
Applicant’s email address
Street address
City
State
Zip code
Primary phone number
Are you currently over 18?
Have you ever been convicted of a felony?
Dates and disposition of case
Type of volunteer work that interests you
How did you hear about our volunteer program?
Why do you want to do volunteer work?
List special training, skills or certifications that would be helpful to CWPD.
What are your interests, hobbies and talents?
Availability
High School Education: Name, Location, Graduation (Y/N)
College Education: Name, Location, Graduation (Y/N), Course of Study
Reference name, email address, occupation and phone number
Name of employer
Employer address
Job title
Summary of job duties and responsibilities
Reference name, email address, occupation and phone number
Reference name, email address, occupation and phone number
Reference name, email address, occupation and phone number
Emergency contact information