Volunteer Application

PERSONAL INFORMATION

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Date of Birth*

Emergency Contact*

First Last

Emergency Contact Phone*

Health Conditions / Allergies / Special Needs

Employer / School

Previous Volunteer Experience

Have you ever been convicted of a felony or misdemeanor?*

Yes
No

VOLUNTEER PREFERENCES

Areas of Interest (check all that apply)*

Maymont Farm / Zoology (age 18+)
Maymont Mansion (age 18+)
Nature Center / Animals / Habitats (age 18+) Environmental Education
Gardens / Horticulture (age 18+)
Special Events
Administration (age 18+)

Availability (check all that apply)*

Do you prefer to volunteer:*

Weekly
Monthly
Occasionally

Are you interested in volunteering as a family or group?*

Yes
No

Are you interested in volunteering to fulfill court-appointed community service hours?*

Yes
No

If yes, provide the following: how many hours, when are your hours due, and why you were given community service. Please note we do not accept community service for all charges.*

Special Skills, Training or Certification

OTHER

How did you hear about volunteering at Maymont?*

Why would you like to volunteer at Maymont?*

Release of Liability*

I agree to the following release of liability: In conjunction with my voluntary involvement undertaken for and with the participation and support of the Maymont Foundation, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge Maymont Foundation, its officers and directors, agents, and volunteers from all claims, demands, and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from negligence, and I agree to release and hold Maymont Foundation, its officers and directors, agents and volunteers harmless from any cause of action, claim or suit arising there from. I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and conditions of this release. I hereby grant Maymont Foundation the irrevocable right to use my name and likeness in any film, video tape, audio tape, photographs, slides, combinations thereof, for inclusion in any promotional or advertising purposes, without any payment to me. By submitting this form, I certify that the information provided in this application is true and correct to the best of my knowledge.

Are you a minor (under 18)?*

Yes
No

If you are under 18, a parent or legal guardian must sign this waiver.*

Volunteer Application

PERSONAL INFORMATION

VOLUNTEER PREFERENCES

OTHER

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