Volunteer Application 2019
Email address *
Last Name *
Your answer
First Name *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Cell Phone *
Your answer
Other Phone
Your answer
Choose times you're generally available to volunteer
Months Available
Areas of Interest
Your answer
Volunteer Requirements
• Complete volunteer application
• Complete annual safety training
• Complete confidentiality / statement of values
• Review Volunteer Protection Act 1997
• Complete liability waiver & photo release
• Complete volunteer background checks
Additional Captain Requirements
• 3 Years boating experience & over 26 years of age
• Hold & maintain a valid drivers license
• No drug or alcohol-related driving driving convictions in past 5 years
• Meet all boat operator insurance requirements.
• Comply with Nebraska State boating regulations
• Complete Live Well. Go Fish. captains boat and truck training.
Please read the following carefully before signing this application:
I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with Live Well. Go Fish. that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by Live Well. Go Fish. organization. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with Live Well. Go Fish. or my termination as a volunteer.
Adult Volunteer Signature & Date
Your answer
Approved Student Volunteer:
I agree to adhere to the policies and procedures of Live Well. Go Fish. and to respect the confidentiality of information pertaining guests, clients and fellow volunteers. If a patient, staff member, volunteer, and/or visitor is abusive, makes inappropriate gestures, advances or conversation, that is in a manner which makes me feel uncomfortable, I will immediately inform my supervisor or Live Well. Go Fish. staff member.
Student Signature & Date (18 & under)
Your answer
The above named student has my consent as parent/guardian to serve as a Student Volunteer with the Live Well. Go Fish. organization. I have read the above agreement as signed by my student and understand their obligation to the program if they are accepted. I also grant permission for my child to receive emergency medical treatment if injured while volunteering
Parent/Guardian Signature & Date
Your answer
A copy of your responses will be emailed to the address you provided.
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