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Volunteer Sign-in Form - COVID-19 (2021)

  1. Instructions
    Volunteers must complete this form before each volunteer shift.
  2. VOLUNTEER INFORMATION
  3. Select the date of your scheduled volunteer shift.
  4. List the time range you will volunteer, from the time you check-in through the time you check-out. The format is h:mm - h:mm (example: 9:00 - 2:00).
  5. List the total number of volunteer hours you will work in the time frame reported (example: 2.5 hours).
  6. COVID-19 HEALTH SELF-SCREENING FOR VOLUNTEERS
  7. Did you complete and pass the Health Self-Assessment?*
  8. If you answered "NO" to the question above, please do not show up for your shift. Instead, email Shelby Krogh, Volunteer & Special Event Coordinator, at shelby.krogh@bothellwa.gov to cancel your RSVP.
  9. VOLUNTEER AGREEMENT
  10. I AGREE TO THE FOLLOWING:*
    I acknowledge that there may be special dangers and risks inherent in my voluntary participation in activities sponsored by the City of Bothell. These risks may be apparent or hidden, known or unknown. These risks are to be taken into consideration in deciding to volunteer, whether my participation is just one time or on multiple occasions. These risks include the possibility of physical injury, loss, death, damage, or other consequences that may arise or result directly from any activity in which I may participate in during this program/project. I desire to participate having determined of my own free will and personal assessment of the risks that I am qualified to participate and willing to accept the risks involved. In consideration of the privilege of participating in this program/project and utilizing any necessary tools, or accessing any public or private property, I hereby assume all risk of personal injury, loss, death, damage, or other consequences. I also forever discharge and waive any right of recovery from, or to bring a claim or lawsuit against, the owners and/or developers of private property which I may need to occupy or cross to access a stream, wetland, field, or project site; and the City of Bothell, its officials, employees, contractors, and other volunteers, agreeing to hold them harmless from any and all claims of negligence for any personal injury, loss, death, damage, or other consequences that I may suffer participating as a volunteer working on activities sponsored by the City of Bothell.
  11. Type your name as your electronic signature confirming the information within.
  12. Leave This Blank:

  13. This field is not part of the form submission.