Parent Volunteer Agreement 17-18
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Complete One Form Per Parent/Guardian.

DEFINED AS: PARENT VOLUNTEERS WHO PERFORM DUTIES ON BEHALF OF THE SCHOOL OR IN OTHER DISTRICT FACILITIES, PRIMARILY DURING THE SCHOOL DAY.

By completing the information below and signing, you agree to the following:

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Douglas County School District
To Maintain Student Confidentiality.
As a Parent Volunteer assisting within the Douglas County School District Re. 1 (“District”), you have been authorized by the Principal or the Principal’s designee to act as a school official subject to the Direction and control of the school’s administrators and teachers.

You understand and agree that your failure to maintain the confidentiality of all school and student information, along with any education records to which you are given access, may disqualify you from further service as a community volunteer in the District.

Consent for a Background Check:
The District may conduct a background check on volunteers who provide service at any District event and/or facility. By providing the information requested and signing below, you consent to the District conducting a background check and understand that the District reserves the right to decline the volunteer service of anyone.
NOTE:
If you are going on an overnight trip, applying to be a volunteer coach, or administering a before or after-school enrichment program, please fill out the Community Volunteer Application and include a photocopy of your driver’s license.
Contact Information
Parent-Guardian-Step-Parent
*
Last Name *
COLORADO Driver's License *
Date of Birth *
MM
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DD
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Email Address *
Street Address *
City
Zip Code
Relationship to Student(s) *
If you are not a parent or guardian of a DCSD student, you must complete the Community Volunteer Application
Placement Information
School Where You Plan To Volunteer
Renaissance Secondary School
Teacher's name, if working in a classroom
(If applicable) Student's Name
(If applicable) Grade
Electronic Signature
By entering my name below, I understand that I am providing an electronic signature which will serve as authorization and verification of the accuracy and completeness of the information I have provided.
I certify that I am 18 years of age or older. *
First Name *
Middle Initial
Last Name *
Date Signed *
MM
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DD
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YYYY
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