Forms • Parks and Recreation Volunteer Form

Name*

Address:*

City, State Zip Code:*

Date of birth (if under age 21):

Telephone number:*

Email address:*

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Are you applying to volunteer in order to fulfill a service requirement?*

Yes

No

If yes, please list the school or organization:

If you are a college student or graduate, please list your major:

Skills, interests or hobbies:

Please indicate your availability (days, seasons, hours, etc.) *

Have you ever been convicted of a felony or class A misdemeanor?*

Yes

No

If yes, please explain:

Do you have any physical or medical limitations, which may interfere with your ability to carry out certain assignments?*

Yes

No

If yes, please explain:

Provide the names and contact information of people we may contact in an emergency:

Name:*

Relationship:*

Phone number:*

Alternative phone number:

Name:

Relationship:

Phone number:

Alternative phone number:

Mark any program(s) for which you would like to volunteer.

SPRING

	Egg Hunt
	Spring Community Cleanup

	Memorial Day Parade
	NewBark PawLooza

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SUMMER

	Camp GWC
	Safe Kids Camp
	Rittenhouse Camp
	Specialty Camps

	Specialty Camps
	Camp REAL
	Liberty Day

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FALL

	Newark Community Day
	Fall Community Clean Up
	Halloween Parade
	Halloween Party at the George Wilson Center

	Turkey Trot 5k/10k Race
	Thanksgiving Day Breakfast
	Mayor’s Fall Harvest Festival

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WINTER

	Winterfest
	Santa’s Secret Shoppe

Snack With Santa

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YEAR ROUND

	Adopt-a-Park
	Eagle Scout Project
	Park Litter Pick Up
	Park & Trail Maintenance

	Community Gardens
	Sports Coaching
	Mayor’s Special Events

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OTHER

After receiving your application, the program coordinator(s) for each program will contact you with additional information regarding your volunteerism. Some programs may require background checks and/or additional information.

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Required If Under 18 Years of Age: I certify that my son/daughter is fully capable of participating as a volunteer and has my permission to be assigned.

Parent or Guardian Name:

Date:

I agree to the terms of the volunteer application.

Yes

No

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Volunteer Policy (read and understand the following)

The City of Newark Parks and Recreation Department, hence forth referred to as the City, cannot guarantee placement. The City will, however, make every effort to match volunteer applicants to volunteer opportunities. The City reserves the right to reject a candidate for any reason which the City, in its sole judgment, determines will or may affect the best interests of the City. Furthermore, the City reserves the right to withhold the reason(s) for such refusal.

The City accepts the service of all volunteers with the understanding that such service is at the discretion of the City. Volunteers agree that the City may at any time, for whatever reason, decided to terminate the volunteers relationship with the City.

Volunteers may at any time, for whatever reason, decide to sever the volunteer’s relationship with the City. Notice of such a decision should be communicated as soon as possible to the volunteer’s supervisor. The City of Newark does not provide Worker’s Compensation or any other insurance coverage for volunteers.*

I have read and understand the above information.

I do not understand the above policy

The City if Newark is an equal opportunity employer. No person or group shall be excluded from participation, denied any benefits, or subjected to discrimination on the basis of race, national origin, or handicap.

* indicates required fields.

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