Teen Volunteer Application
Please fill out this form completely. Please note that not all items will apply to virtual volunteering. Please email Teen Librarian Jenny with any questions or concerns at jennyc@burlingtonwa.gov.
Email *
First and last name *
Parent or legal guardian's first and last name *
Do you check this email regularly? This will be the way Jenny contacts you about volunteering. *
Your Birthday *
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Are you over the age of 18? *
Do you speak Spanish?
Clear selection
In case of emergency, who should we contact? Please provide their name, relationship to you, and phone number. *
Please indicate your agreement to the following requirements by selecting each one. *
I agree.
I am not to appear for volunteer service under the influence of illegal drugs or alcohol
I am not to have children with me during my volunteer activities, that are under 14 years of age, unless they are volunteers approved by the City and I am supervising them.
I will abide by the highest standards of personal conduct while performing volunteer services, behaving professionally with members of the public. If difficulties arise I will seek help from library staff.
I agree not to go beyond the scope of volunteer work for which I receive direct training. It is my responsibility to understand the tasks I am trained to provide completely, or ask questions until I feel confident to perform them.
I understand that I am to report any on-the-job injury or illness, no matter how minor, to my supervisor, and complete an accident form (only applicable on-site at the library).
Please indicate your ability to meet the following requirements by selecting each one. *
I agree.
Speak and understand English; convey a positive, friendly attitude.
Work congenially with staff, patrons and other volunteers.
Understand and follow written and verbal instructions, policies and procedures.
Receive instruction from library staff and abide by library policies and regulations.
See and hear with enough accuracy to meet general communication needs.
Walk and balance safely while pushing heavily-laden wheeled carts (only applicable on-site at the library).
Work safely at shelves near floor or above my head occasionally (only applicable on-site at the library).
Lift, carry and/or move materials and furniture as necessary (only applicable on-site at the library).
NOTICE TO VOLUNTEERS
Volunteers are not considered to be City of Burlington employees. Medical bill compensation may be available through the Department of Labor & Industries if a volunteer is injured in the scope and course of volunteering. Volunteer service is considered to be credible work experience. The data furnished on this form is furnished voluntarily and will be used to contact, interview, and place volunteers.
SIGNATURE IS REQUIRED
To the best of my knowledge, the information herein is true and complete. I understand that falsification of this application is grounds for dismissal as a volunteer. Further, I, or my parent/legal guardian, give permission for an authorized representative of the City to conduct a national background check in accordance with RCW 43.43.830-839 and to inquire of individuals/references about my ability to perform all aspects of the volunteer position for which I am being considered and I, or my parent/legal guardian, release the City of Burlington and those individuals/institutions that provide information from any liability that may arise from the provision of this information.

As a volunteer for the City of Burlington, or the parent/legal guardian of a volunteer, I am fully aware that the work associated with being a City Volunteer involves certain risks of physical injury or death. By signing this agreement, I also acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I or my child or children may be exposed to or infected by COVID-19 by participating in volunteer activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 while performing volunteer activities may result from the actions, omissions, or negligence of myself and others, including but not limited to City employees, volunteers, and program participants and their families.

Being fully informed as to these risks and in consideration of being allowed to participate in the City's Volunteer Program, I hereby assume all risk of injury, damage and harm to myself (if 18 years old or older), or as the parent/legal guardian of a minor child, arising from such activities or use of City facilities. I also hereby individually and on behalf of my heirs, executors and assignees, release and hold harmless the City of Burlington, 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, or my minor child, arising out of the volunteer activities.
I, volunteer or parent/legal guardian, give permission to have my photo taken and used for publicity purposes by the City. *
I, volunteer or parent/legal guardian, authorize any necessary emergency medical treatment that might be required for in the event of physical injury and/or accident to while participating in this program. *
Signature (type your name) and date: *
If under 18, parent or legal guardian's signature and date: *
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