Form Dcr199-051 - Group Volunteer Application
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2GROUP VOLUNTEER APPLICATION
Volunteer
Location
NAME OF GROUP _____________________________ Group Size _____ Group Age Range _______
Mailing Address __________________________________________ Apt. # ____________________
City ____________________________________
State _______
Zip ________________
CONTACT PERSON
Last Name ______________________________ First _________________________ MI __________
Home Phone (_______) __________________
Cell/Business Phone (_______) ___________________
Email Address _______________________________________
Alternate Contacts: List 2 people other than yourself who can serve as group contacts
Name
Phone
Email
(1) _______________________________ _____________________ _________________________
(2) _______________________________ _____________________ _________________________
VOLUNTEER INTERESTS (Check all that apply.)
___
___
Visitor Services (visitor center, host, greeter)
Administration/Office
___
___
Maintenance (buildings, grounds)
Interpretation - Environmental
___
___
Resource Management (trails , cleanups, water quality)
Interpretation - Historic/Cultural
___
___
Skilled Labor (explain skill) _____________________
Special Events
___
Other (explain) _______________________________
VOLUNTEER AVAILABILITY (Check all that apply.)
___
___
___
___
Summer
Fall
Winter
Spring
___
___
___
___
___
___
Sat
Sun ____
Mon
Tue
Wed
Thur
Fri
___
___
___
___
Morning
Afternoon
Evening
Special events/Projects
CONSENT FOR MINORS: (To be completed if volunteers are under age of 18)
Our organization has obtained permission from parents/guardians of minors to participate in this group volunteer project. I
understand that outdoor activities have potential risks and assume responsibility for minors in our group.
Signature of Group Representative _____________________________________
Date _________________
VISUAL IMAGE RELEASE
While volunteering our services at Virginia State Parks, we hereby consent to the use of visual images taken of group members
for the purpose of advertising, promoting, offering the benefits of or teaching about the facilities and services of Virginia State
Parks. We need not inspect or approve the finished product of any copy using our image.
Signature of Group Representative ____________________________________
Date _________________
PLEASE CONTINUE ON BACK
(DCR199-051) (08/06)
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