1. Ways To ApplyMail City of Newark Parks & Recreation Department 220 South Main Street Newark, DE 19711 Walk In (Monday - Friday 8:30am - 5pm) City of Newark Municipal Building Parks & Recreation Department 220 South Main Street Newark, DE 19711Fax (302) 366-7169Online www.cityofnewarkde.us/parksrecreation City of Newark Parks & Recreation Department Volunteer Application For additional information, please call (302) 366-7000 Email Chrissy Palmer at cpalmer@Newark.de.us Visit us online at www.cityofnewarkde.us/parksrecreation Required If Under 18 Years of Age I certify that my son/daughter is fully capable of participating as a volunteer for the City of Newark and has my permission to be assigned. I have also read and understand the volunteer policy listed below. Signature of Parent or guardian ___________________________ Date ______________ IMPORTANT: VOLUNTEER POLICY Make sure you have read and understand the following: I understand the risks involved in being a volunteer for Newark Parks and Recreation and that transportation to and from the project site may be provided on park work vehicles run by park employees who are fully trained to operate such equipment. I understand that neither the City of Newark, nor Newark Parks and Recreation, nor any city employee, will assume any financial liability for any injury or illness that I, or any family member or friend might incur while performing voluntary service for Newark Parks and Recreation. Volunteers agree to perform service without compensation and are not considered employees of the City of Newark. Newark Parks and Recreation does not provide Worker’s Compensation or any other insurance coverage for volunteers. Volunteers agree to adhere to Parks and Recreation rules and procedures. Furthermore, volunteers agree not to attempt work that is beyond their abilities or for which the volunteer has not been assigned, trained, or authorized. Newark Parks and Recreation cannot guarantee volunteer placement. The City will, however, make every effort to match volunteer applicants to volunteer opportunities based on the needs of Newark Parks and Recreation and the interests and abilities of the volunteer. Newark Parks and Recreation accepts the service of all volunteers with the understanding that such service is at the sole discretion of the City. Volunteers agree that the Newark Parks and Recreation Department and the volunteer may at any time, for any reason, decide to terminate the volunteer’s relationship with the City. Notice of such a decision should be communicated as soon as possible to the volunteers supervisor. _____________________________________________________________________ (Signature of Volunteer)(Date) Emergency Release Waiver The undersigned, as parent/guardian of __________________ hereby authorize the City of Newark, Department of Parks & Recreation and the Newark Medical Center to provide and render necessary medical care and treatment of the aforesaid child of any illness or injury, which child may suffer at any time while in their custody. It is understood that time permitting, specific permission of the parent/guardian will be secured in the event of any medical treatment or surgery is to be undertaken, but that, should an emergency arise, this authorization and consent will cover such event. Also, I(we) hereby accept responsibility for any accident which may occur in connection with this activity, hold harmless the City of Newark, and all other parties involved in the promotion and/or conducting of the above named activity. As well, I (we) understand that the City of Newark provides NO medical insurance coverage or workers compensation for this volunteer activity. I give permission for myself and/or my child to be photographed while participating and/or attending a Parks and Recreation activity. I understand that photos may be used in future publicity. Signature of Applicant or Parent/Guardian if under 18 Date

2. Emergency Contact Information 1. Name ___________________________ Phone Number ________________ Relationship _________________ Alternate Phone Number _______________ 2. Name ___________________________ Phone Number ________________ Relationship _________________ Alternate Phone Number _______________ Name _________________________________________________________ Address _______________________________________________________ City _______________________ State _______________ Zip Code _______ Birthdate Month ____________ Day _____________ Year _____________ Phone Home _______________ Work ______________ Cell _________ Email Address ___________________________________________________ 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.) ______________ ______________________________________________________________ Please place an X in the box next to any program(s) that you would be interested in volunteering for. Thanks for your interest in volunteering with the City of Newark Parks and Recreation! After receiving your application, a recreation specialist will contact you with additional information regarding your volunteerism. Some programs may require background checks and/or additional information. Winter ____ Santa’s Secret Shoppe ____ Snack With Santa ____ Basketball Coaching ____ After School Center Year Round ____ Adopt-a-Park ____ Eagle Scout Project ____ Park Litter Pick Up ____ Park & Trail MaintenanceOther ___________________________ ___________________________Spring ____ Community Clean Up ____ Egg Hunt ____ Memorial Day Parade ____ After School CenterSummer ____ Liberty Day ____ Safety Town ____ Camp GWC ____ Rittenhouse Camp ____ Specialty CampsFall ____ Newark Community Day ____ Fall Community Clean Up ____ Turkey Trot 5K/10K Run ____ Halloween Parade ____ Halloween Party at GWC ____ Soccer Coaching ____ After School Center 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: Y / N If yes, please explain: ___________________________________________ City of Newark Parks & Recreation Department Volunteer Application