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2. First Name*
3. Last Name*
5. Date of Birth*
   Date of Birth
7. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Alternate/Home Phone Number
18. Email*
20. Emergency Contact Name*
21. Relationship*
23. Emergency Contact Phone Number*
24. Alternate Emergency Contact Phone Number
26. Are you volunteering for school credit?*

    1. Yes
    2. No
28. How many hours do you wish to obtain?*
29. By what date do the hours need to be completed?*
31. Name of School or College*
32. In conjunction with a club/organization?*

    1. Yes
    2. No
34. What is the name of the club/organization?*
36. Please tell us briefly the reason you wish to be a volunteer/how you can benefit the Town of Carrboro:
38. Have you volunteered in the past with the Carrboro Recreation and Parks?*

    1. Yes
    2. No
40. If yes, in what capacity with that event / program (i.e, youth coach, special events, etc)?*
42. Are you interested in working a special event?*

    1. Yes
    2. No
44. Note: Hours for special events vary. Are you flexible with your availability?*

    1. Yes
    2. No
46. The need for assistance at special events may vary in nature. Do you have any experience or interest that could be considered in your assignment?
48. Are you interested in being a head coach for a youth athletic team?*

    1. Yes
    2. No
50. Please select the coaching opportunity for which you are applying:*
    -- Select One --AnyYouth Baseball - SpringYouth Baseball - FallYouth BasketballGirls Field HockeyGirls Volleyball - SpringGirls Volleyball - Fall
52. Which age group would you prefer to work with?*
    -- Select One --Any8 & Under10 & Under12 & Under13 & Above
54. Are you interested in volunteering for a summer camp?*

    1. Yes
    2. No
56. Which type of camp do you prefer to work with (Indicate Sports Camp, Theme Camps, Kinderventures, or Any)?*
58. Which age group would you prefer to work with?*
    -- Select One --Any3-5 year-olds6-9 year-olds9-12 year-oldsTeen
60. Summer Camps are held in the mornings and/or afternoons, during the weekdays. Are you available AM, PM, or both?*

    1. AM
    2. PM
    3. Both
62. Do you wish to volunteer for an opportunity not listed on this form?*

    1. Yes
    2. No
64. What are your interests? (Make flyers, filing papers, working with Senior Citizens, working with people with special needs, art, music, etc.)*
66. How often would you like to volunteer?*
    -- Select One --1-2 times per week3-4 times per weekA few days per monthAs needed
68. Do you have any questions about volunteering with the Town of Carrboro's Recreation & Parks Department?
70. References
    Please provide references that can attest to any related work/volunteer experience. Note: If unable to provide work-related or volunteer references, please use personal (non-family) references that can attest to your ability to work with the public.
72. Name*
73. Email
74. Phone Number*
76. Name*
77. Email
78. Phone Number*
80. Name
81. Email
82. Phone Number
84. Town of Carrboro, North Carolina, Volunteer Waiver Form
    I, the undersigned volunteer for the Town of Carrboro, North Carolina Recreation and Parks Department, hereby acknowledge that I am participating as a volunteer with the Carrboro Recreation and Parks Department, and that I am not an employee of the Town of Carrboro, or its Recreation and Parks Department. I acknowledge that there is a risk of physical injury that is associated with some activities of the Carrboro Recreation and Parks Department, and I hereby agree to waive and hold the Town of Carrboro and its Recreation and Parks Department harmless from any claims for damages due to an injury I may suffer during the course of my volunteer activities. I also specifically acknowledge that as a volunteer, I am not entitled to worker's compensation from the Town of Carrboro for any injuries I may suffer during the course of my volunteer activities.

    
    Note: If under 18 years of age, parent/guardian must complete signature field.

    
    Note: If your application is accepted, the Carrboro Recreation and Parks Department may conduct a Criminal Background Check, based on the nature of the program or event.

86. Signature*
88. Date of Signature*
    Date of Signature
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90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit Submit and Print

* indicates a required field