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General Volunteer Application

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First Name
Last Name
Maiden Name or Alias
Position Desired
Home Phone
Work Phone
Address
City
State
Zip Code
Date of Birth
Date of Birth
Sex
Race
Drivers License/State ID Number
DL State
Social Security Number
Criminal Background Check Release Form
I understand that a successful criminal background check is a condition of volunteering at the Village of Riverside and that while I may begin after a criminal background search has been initiated, such work will e conditional pending the return results of said search to the Village of Riverside.

I consent to the Village of Riverside obtaining my criminal conviction and arrest history from the Illinois State Police or the FBI. I understand that all information obtained is considered confidential and will be treated as so.

I understand I will be provided a copy of the criminal background check if any convictions or arrests are reported, and my duty under the law to notify the Village of Riverside within 7 working days if the information is inaccurate or incomplete.

I hereby fully release and discharge the Village of Riverside, and any agents thereof, from any and all claims for damages or injury that may arise from my participating in or as result of the criminal background check.

I have read and fully understand this release form.
1. I agree.
Printed Name
Date
Date
Signature
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Volunteer Liability Release Statement

I, ________________________________________________________, (hereinafter referred to as a Volunteer), do hereby acknowledge that in order for me to be accepted as a Village Volunteer I acknowledge, understand, and agree to the following conditions of participation:

1. The Volunteer does hereby agree to release and forever discharge the Village of Riverside, the Board of Trustees, and their officers, agents, and employees, and servants from all actions, suits, debts, sums of money, accounts and all claims and demands of whatever nature, in law or in equity, including but not limited to, any and all future claims for property damage or bodily injury arising out of the Volunteer’s service and further agrees to waive any and all claims and demands of whatever nature, in law and equity arising out of the Volunteer’s participation to serve the Village of Riverside.

2. The Volunteer further agrees that the Village of Riverside, the Village Board of Trustees, their officers, employees, agents, and servants shall not be liable under any circumstances for any loss or damage whatsoever, whether direct, indirect, consequential or resultant, including without limitation, death, personal injury and loss or damage to any property whatsoever arising out of or resulting from or connected with the Volunteer’s participation, whether or not such injury, loss or damage is caused by the negligent acts or omissions to act on the of the Village of Riverside, Village Board of Trustees, or their officers, employees, agents, or servants; and further, agrees that all risks in connection with any act or failure to act arising directly or indirectly from the Volunteer’s participation are assumed solely, fully, and completely by the Volunteer.

3. The Volunteer agrees to defend, protect, save harmless, and indemnify the Village of Riverside, the Riverside Board of Trustees, and their officers, employees, agents and servants from any and all liability, suits claims, demand, damages, costs and expenses, arising out of or claimed to be arising out of or resulting from or claimed to have resulted from any injury or damage to the person or property of the Volunteer or any other person arising out of Volunteer’s participation whether or not such injury or damage is caused by the negligent acts or omissions to act on the part of the village of Riverside, the Riverside Board of Trustees, or their officers, employees, agents, or servants.

4. The Volunteer understands that he/she is not an employee of the Village of Riverside, or any agency that he/she may be assigned to, through his/her participation.

I, ____________________________________________________________ state that I have read this entire acknowledge, understand all its terms, and execute it voluntarily with full knowledge of its significance. In witness thereof, I have executed this acknowledgement at Riverside, Illinois this:
Date
Date
List Children's Names and Ages
Group Affiliation
Signature
Name (print)
Phone Number
Address
City
State
Zip Code

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