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Agency Name, Duties, Number of Years
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Other Than Relatives
I understand that I am asking to provide volunteer services to the city and the city is not be responsible for any injuries that may be sustained when providing the volunteer activity. Unless the city acts in a negligent manner, I shall assume all liability for my actions, and hold the City of Maple Grove harmless from any and all claims for damages, actions, or causes of action which are in any way connected with the volunteer activities that I am doing.
I understand that I am not an employee of the City of Maple Grove and am a volunteer. Consequently, I understand and agree that I am not covered by the city's worker's compensation, nor any other city plans of benefits. Further, I understand and agree that my actions do not obligate or become the responsibility of the City of Maple Grove.
I understand that some of the information I provided on this application is considered private data and will be used only to determine volunteer placement. Refusing to provide this information may cause difficulties for City of Maple Grove staff in determining volunteer opportunities. This information provided will only be accessible to myself, appropriate city staff, or as authorized by state statutes.
I verify this information is correct and I understand I am applying for a volunteer position.
By typing your name into this field you authorize the City of Maple Grove to consider this an electronic signature.
For many volunteer positions, all that is required is a willingness to help. However, a screening process may be required for some positions.
Questions? Email the city volunteer coordinator or call at 763-494-6512.
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