VOLUNTEER FORM MAIL-IN OR DROP OFF FORM AT:


Lisle Park District, 1925 Ohio Street, Lisle, IL 60532 Attn: Lisa Leone


PLEASE PRINT 


Date............/.............../.................... Company / Group (if applicable)................................................................................................................................. Last Name.................................................................................................................... First Name............................................................................................. Street Address...................................................................................................................................... City............................................... Zip............................ Home Phone (..............) .................-................... Work Phone (................) .................-................... Cell Phone (...............) ................-................ Email Address ........................................................................................................ Please add me to the e-newsletter list: oYes oNo Driver’s License Number ....................................................................................... Issuing State ............................. Birthdate ........../........./.......... Have you previously volunteered here? oYes oNo If yes, list dates: .................................................................................................. I Can Volunteer: ............Hours Per oDay oWeek oMonth Days Available: oM oTu oW oTh oF oSa oSun Time of Day: oMorning (7:00am - Noon) oAfternoon (Noon - 5:00pm) oEvening (5:00pm - 9:00pm)


Volunteer areas you are most interested in: Please explain below what interests you have as a volunteer for the general area selected on reverse side of form. Include any relevant skills, experience and/or education. ....................................................................................................................................................................................................................................................................... ....................................................................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................


References: Name................................................................................................................................................. Relationship .......................................................................


City................................................. Phone (.................) ...................-....................... Email........................................................................................................


Name................................................................................................................................................. Relationship ....................................................................... City................................................. Phone (.................) ...................-....................... Email........................................................................................................


Emergency Contact: Name.................................................................................................................................................. Relationship .......................................................................


Street Address..................................................................................................................................... City............................................... Zip............................. Home Phone (...............) .................-.................... Work Phone (...............) .................-................... Cell Phone (..............) ................-.................... Email Address ...................................................................................................................................................................................................................................


AGREEMENT: The Lisle Park District appreciates your willingness to volunteer your services to assist the district, its patrons, and the commu- nity. In signing this form as a Volunteer you are acknowledging that your services for the District are gratuitous and are intended as a contribu- tion by you for public service for the District, its patrons, and the community and as such, that you will be entitled to no compensation or any fringe benefits or other employment rights applicable to the employees of the Lisle Park District. It is expressly understood that you are not an employee or agent of the Lisle Park District and that we will provide you with necessary information and guidance to perform your volunteer services. For any reason whatsoever, either you or the District may terminate this volunteer agreement. While on the District premises you will agree to abide by all of the rules of conduct governing the staff and employees of the department in performing your services. Your signature below authorizes the Lisle Park District to conduct background checks on the information provided; I certify that the information provided is true and accurate to the best of my knowledge.


Volunteer’s Signature............................................................................................................................................................ Date............/.............../.............. 63 Celebrating 50 Years


Parent/Guardian’s Signature............................................................................................................................................... Date............/.............../.............. (if volunteer is under 18 years of age)


PARK DISTRICT Creating Opportunites Since 1967 | BROCHURE Winter / Spring 2017


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