people sitting at picnic table with fishing poles

Centerville-Washington Park District Youth 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.

Youth Volunteer Application

Fields marked with an * are required.

Full name
Email address
Street address
City
State
Zip Code
Primary phone number
Parent or guardian’s full name(s)
Availability
Do you have relatives employed by the park district?
Relative information
Type of volunteer work that interests you
How did you hear about our volunteer program?
Why do you want to do volunteer work?
What are your interests, hobbies and talents?
Reference name, email address, occupation and phone number
Reference name, email address, occupation and phone number
Reference name, email address, occupation and phone number