Holland Recreation center badge

Volleyball Volunteer App

Release of Liability

The Holland Recreation promotes a non-discrimination policy that ensures participation for all regardless of race, religion, sex, economic status or disability.  In accordance with A.D.A. requirements, if I require special accommodations to perform my services, I must notify Holland Recreation of that need within 182 days after I knew or reasonably should have known that special accommodations were needed.  Failure to do so will bar me from alleging that the City of Holland has not accommodated me as required by law.

I hereby certify that all statements on this application are made truthfully and without evasion, and further understand and agree that such statements may be investigated and if found to be false will be sufficient reason for not being accepted as a volunteer, or it accepted may result in my dismissal.

Should the City determine it necessary to do so, I authorize the City of Holland to secure additional information from my employer, prior employer, educational institutions, or any other persons or organizations which may give the City of Holland information concerning my employment/educational accomplishments, disciplinary information or any other personal information they may have, personal or otherwise, and release all parties from all liabilities for any damage that may result from furnishing this information to the City of Holland.

In consideration of serving as a volunteer coach with the City of Holland.  I am hereby requesting a local and state background history on myself.  I understand that this is only a State of Michigan background check.  If necessary, I will furnish necessary identification (i.e. fingerprints, driver’s license & social security number) for such an investigation to take place.  I hereby authorize the HOLLAND RECREATION AND/OR HOLLAND POLICE DEPARTMENT to release any information it may have in its records or may obtain from other sources under my own name and birth date, including my fingerprints, and I hereby release and forever discharge the City of Holland and its agents, its officers and employees from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury, which may be sustained by me in the nature of libel, slander, invasion of privacy or other results from errors or omissions in the information given or from the use of the information, whether by reason or unauthorized use, negligence or otherwise.

I agree to abide by all program rules and regulations set forth by Holland Recreation.  I understand that my volunteer services may be terminated at any time by the Holland Recreation Division.  I also understand that there are certain inherent risks involved in any activity.  I do hereby waive, relinquish, release, discharge and hold harmless Holland Recreation and its employees, volunteers, contributing sponsors and affiliate organizations from any and all liability for any physical or mental injury or aggravation of any pre-existing condition, illness or disability, death, loss of enjoyment or any other harm or loss of any nature which may be sustained by me while serving as a volunteer for the Holland Recreation Division.

Volunteer Coach Code of Conduct

Please read over the volunteer coach code of conduct found here.

Release of Liability
select
Do you agree with the information above?
Code of Conduct
select
Do you agree to the volunteer code of conduct? (Refer to the above section titled Volunteer Coach Code of Conduct)
First and Last Name
Middle Initial
Address
City
State
Zip Code
Place of Employment
Occupation
E-mail Address
Phone Number
Emergency Contact
(Name)
Em. Contact Phone
(Emergency Contact Phone Number)
Em. Contact Relation
Activity
What activity are you volunteering for?
Position of Interest
Coach, Asst. Coach, Event Staff, etc.
T-shirt Size
Family Member
Name and your relationship to any family members in this program?
Previous Volunteer
If you have been a previous volunteer, what has been your role?
Felony
If you have been convicted of a felony please explain the offense.
Conviction w/ Minor
Have you been convicted of an offense involving a minor? If so, explain.
Pending Felonies
Do you have any pending felonies? If so, explain.
Experience
What experiences qualify you for this position?
Why
Why are you applying?
Social Security #
Gender
Date of Birth
RadDatePicker
RadDatePicker
Open the calendar popup.
Driver's License #
Correct Information?
select
Do you certify that all the information submitted on this electronic form is correct?
Electronic Signature
Your Name
Required Fields