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2. I hereby volunteer my services to perform only the services as outlined in the attached scope of volunteer work for the of the City of Washougal. I understand I will not be compensated for my work, but I will complete my volunteer duties in a responsible manner. If I decide to discontinue my volunteer service, I will notify the Community Engagement Coordinator.*
4. Further, I hereby certify I am capable of performing the duties as outlined in the attached scope of volunteer work (check which applies):*

   1. Without accommodation
   2. With accommodation
6. Please list accommodations:*
8. In consideration of the city giving me permission to perform these volunteer services, I agree to the following terms (initial each):
10. 1. I understand I am not to appear for volunteer service under the influence of any drugs or alcohol.*
12. 2. I will abide by all city’s policies regarding personal conduct while performing volunteer services.*
14. 3. I agree not to go beyond the scope of volunteer work agreed to without authorization.*
16. 4. Should an injury occur during the scope of my service, I understand that: The City has included my hours of volunteer service in the Washington State Department of Labor and Industries coverage for volunteer workers.*
18. 5. I understand I am to report any on-the-job injury or illness, no matter how minor, to the city’s community engagement volunteer coordinator*
20. 6. I am fully aware that the work associated with being a Volunteer involves certain risks of physical injury or death. Being fully informed as to these risks and in consideration of my being allowed to participate in the Washougal Volunteer Program, I hereby assume all risk of injury, damage, and harm to myself arising from such activities or use of Washougal facilities. I also hereby individually and on behalf of my heirs, executors and assignees, release and hold harmless the City of Washougal, its officials, employees, volunteers and agents and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising out of my volunteer activities, except for those caused by the sole negligence of the City of Washougal.*
22. 7. I understand I or the city may terminate this agreement at any time without cause, that I am volunteering my services at will and may be asked to discontinue such without prior notice or reason.*
24. 8. I give permission for photos/videos taken of myself during volunteer activities to be used for publicity purposes, without recompense*
26. I authorize any necessary emergency medical treatment that might be required for me in the event of physical injury and/or accident to me while participating in this program. *

    1. Yes
    2. No
28. This agreement will be in effect for one year, beginning on this date.
29. Enter date.*
    Enter date.
31. Electronic Signature*
33. Volunteer Contact Information
35. Name*
36. Email Address*
38. Address*
40. City*
41. State*
42. Zip Code*
44. Phone Number*
45. DOB:
47. I hereby certify that I am:*

    1. An adult aged 18 or over
    2. A minor under the age of 18
49. Parent/Legal Guardian*
51. If you are volunteering for a specific event, please list it here.
53. Opportunity of Interest*

    1. Parks and Community Garden
    2. Trails Management
    3. Special Events
    4. Community Aesthetics
    5. "Washougal Wins" Program

    Select all that apply.

55. Contact

    Please contact Washougal Community Engagement Team by emailing volunteer@cityofwashougal.us or calling 360.835.8501 for additional information. 

Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field