Juneau Parks and Recreation Volunteer Application

"*" indicates required fields

I am applying to volunteer for the Juneau Parks and Recreation Department as a Youth Sport Coach. I agree to follow the direction and supervision of department personnel, and follow all rules and policies. I understand that although the department appreciates my services, I serve solely at the will of the department without compensation or benefits and that I have no authority to act on behalf of the department or the City.

I will sign and submit a consent form to CBJ Parks & Recreation in order for the department to obtain my background check. My background check will be a part of my application as a volunteer, and I understand that this application, any criminal record, and any information received by the department is public and issubject to disclosure as are all public records.

I promise that the following information is accurate and complete, and that I will inform the department of any changes in the information as soon as it occurs. I promise and affirm that I will make my best efforts to keep the participants I work with safe from harm, and that I will promptly inform the department of any safety or other concerns which I may have in regard to my involvement with the department’s programs.

Name*

First Last

Home Phone*

Work Phone*

Mailing Address*

Street Address City ZIP Code

Physical Address*

Street Address City ZIP Code

Email*

Length of time at current address*

Are you current in CPR/First Aid?*

CPR Expiration*

First Aid Expiration*

Sport you wish to volunteer for:

Age group

*Age groups may change due to low enrollment numbers.

Please list prior addresses and dates of residence for the past 10 years:*

Please list your prior experience working with youth, name of organization, age of youth, and description of activities:*

List three references that have seen you work with youth and have knowledge of your character, experience and ability. Please list both phone numbers so we may contact your references.

Reference 1 Name*

Reference 1 Relationship*

Reference 1 Phone Number*

Reference 1 Email*

Reference 2 Name*

Reference 2 Relationship*

Reference 2 Phone Number*

Reference 2 Email*

Reference 3 Name*

Reference 3 Relationship*

Reference 3 Phone Number*

Reference 3 Email*

Have you been convicted of any crimes within the past 10 years?*

(A crime is punishable by imprisonment, do not list infractions punishable only by fines.)

Yes

Name of Offense*

Date of Conviction*

State/City/Name of Court*

Have you been convicted of sexual abuse of a minor?*

Yes

Name of Offense*

Date of Conviction*

State/City/Name of Court*

Have you ever been convicted of any crime where a minor is a victim?*

Yes

Name of Offense*

Date of Conviction*

State/City/Name of Court*

Have you ever been convicted of a crime involving controlled substances?*

Yes

Name of Offense*

Date of Conviction*

State/City/Name of Court*

I understand that I will need to sign the application at a later date before the start of the season to affirm that all what I have stated in the above is true to the best of my knowledge.*

I understand

CAPTCHA

PARKS & RECREATION

Juneau Parks and Recreation Volunteer Application

Zach Gordon Youth Services

Parks & Recreation