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2. First Name
3. Last Name
5. Home Phone Number
6. Cell Phone Number
8. Email Address
10. Address
12. City
13. State
14. Zip Code
16. Emergency Contact Name
17. Emergency Contact Phone Number
19. Agreement by Volunteer:*

    1. I agree to volunteer my services to the Village of McFarland in accordance with the following understandings:

                                                          

    1. I will offer my services with no expectation of pay, benefits or other privileges of employment of any kind. I certify that I have not been promised and have no expectation that I will receive a paid position as a result of my volunteer work.
    2. I understand that placement into volunteer positions are at the sole discretion of the Village of McFarland. Accordingly, my volunteer assignment/service may be withdrawn or terminated at any time.
    3. My volunteer service will not confer on me the status of a Village employee, while acting within the scope of this Agreement.
    4. I understand my job duties and the potential hazards/risks that are involved, if any, for this volunteer position based on attached job description. I understand it is my responsibility to be aware of my physical condition and I will not engage in physical activities that are beyond my capabilities. I will notify my volunteer coordinator/supervisor of any significant change in my ability to do the work. If special skills are required for this project, I acknowledge I have been appropriately informed of the required tasks.
    5. I grant the Village permission to use my image in any and all publicity, advertising, and other materials, including websites and other electronic forms, or any other uses the Village may deem proper. I waive any right to payment, royalties or any other consideration for use of the image in perpetuity.
    6. I hereby hold harmless and release and forever discharge the Village of McFarland, its officers, agents, employees and volunteers from all claims, demands, and causes of action which I, my heirs, representative, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have which arises out of or is in any way connected with this agreement.
    7. If I drive a personal vehicle to and from a volunteer project, I certify that all vehicles are properly insured as required by Wisconsin State Law.
    8. I understand and agree that the Village is not responsible for any of my personal property that is lost, damaged, or stolen while I am participating as a volunteer.
     9. No personal services, items or products can be marketed to individuals or departments as a result of knowledge obtained in the volunteer role. 

                           

    I have read and agree to the terms and conditions of the Volunteer Waiver as stated above. 

21. Volunteer Signature or Legal Guardian
22. Date
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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