What's your email address?

Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
What is your date of birth? *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Phone Number *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, Town of Parker will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Do you have a particular interest? *





Are you trying to obtain court ordered community service? *
Emergency contact and phone number? *
If you are a minor, please provide email of parent/guardian *
How did you hear about the Volunteer Program? *
Are you interested in volunteering on a regular basis? *

Disclaimer


Who is this registration for?

I, the undersigned (“I” or “Undersigned”), agree to volunteer for the Town of Parker (the “Town”) for the program specified below (the “Program”).

If signing on behalf of a minor I, the undersigned (“I” or “undersigned) am signing on behalf of a minor of who I am the parent or guardian and hereby consent that the minor act as a volunteer with the Town of Parker.

I agree to comply with all rules, standards, and specifications established by the Town with respect to volunteering for the Program. I understand that my volunteer services may be terminated by the Town at any time for any reason. Further, I acknowledge that I am in no way considered an employee or an independent contractor for the Town as part of my volunteer activities.

I understand that the activities involved in volunteering for the event may contain an element of hazard or risk. Further, I understand that there may be other risks not known or reasonably foreseeable at this time and that such risks shall be assumed by the Undersigned. I agree to indemnify and hold the Town of Parker, its officers, agents, consultants, and representatives harmless from any loss, damage, or injury, which may result from my participation in the volunteer activities. This release of liability and indemnity applies equally to losses, damages, or injuries caused or alleged to be caused in whole or in part by the negligence of the Town.

I further agree to release, waive and discharge, and covenant not to sue the Town, its officials, employees or volunteers for any claims, demands or actions whatsoever arising out of any damage, loss, injury or death to the Undersigned that may result from participating in the Program. This release of liability and indemnity applies to Undersigned, as well as any personal representatives, assigns, heirs and next of kin.

I understand that the Town does not provide accident, health, workers’ compensation, or life insurance coverage for the Undersigned during Program participation.

I have read and fully understand the effect of the relinquishment of the rights that I hereby waive and I sign this waiver and release voluntarily.

I grant the Town full permission to use my photographs, videotapes, or any other manner of recording my participation in this Program for any purpose.