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Dear Volunteer,
Please read the statements below. The electronic signature acknowledgement is located on page one of the document.

Thank you for completing this form!

City of Salina's Parks & Recreation Department
Salina Fieldhouse
(785) 833-2260

Volunteer Waiver:
· I do hereby acknowledge that I have chosen to be a volunteer for the City of Salina’s Parks & Recreation Department with the full knowledge of the risks involved.
· I hereby agree to assume those risks and to hold the City of Salina and all of its representatives free from liability for any injury, harm and complication resulting from said volunteering.
· I do understand that accident insurance and worker’s compensation are not provided by the City of Salina’s Parks & Recreation Department.
· I hereby agree to assume full responsibility for any and all medical expenses resulting from any accidents or injuries suffered by me.
· I have read and understand this waiver statement.

I, the volunteer, understand and agree to:
· The City of Salina can deny any volunteer for any non-discriminatory reason.
· This enrollment form is valid for one year and a new form has to be submitted immediately thereafter.
· By submitting this enrollment form, I the volunteer, affirm that all the foregoing information I have provided is true and correct.
· By submitting this enrollment form, I the volunteer, agree that if any of the foregoing information is incorrect, I will forever indemnify and hold the City of Salina harmless for any acts or omissions on my behalf as they relate to any incorrect information that I have provided.
· By submitting this enrollment form, I the volunteer, voluntarily waive my privacy rights to the extent necessary for the youth organization to verify the foregoing information through any reasonable means, including, but not limited to local, state, national and international criminal background checks and to inform those within the City of Salina who are responsible for accepting and/or supervising volunteers.
Please check that you agree before continuing.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.
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