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Print Name:

____________________________________________________________________

Home Phone:

____________________________

Cell Phone:

______________________________

Address:

_______________________________________________________________________

City:

___________________________________________

State:

________

Zip:

______________

Email

(required)

:

_________________________________________________________________

Are you under 18 years of age?

YES

NO T-shirt Size S M L XL XXL

Emergency Contact Information:

Name ____________________________________________Cell #__________________________________

Relationship to the volunteer__________________________

Is this for community service hours? If yes, write in school or church__________________________________

1

3

________________________________________________________________

___________________

Parent/guardian signature of minor volunteer

Date

Events with multiple dates, choose one or more days to volunteer. You will be called if needed.

2

Share your time and talent with the Village of Orland Park where you can make a difference. The Village of Orland Park offers

a wide variety of volunteer opportunities throughout the season. If you are interested in volunteering at any of our events please

mail or drop off this form to the Recreation Administration Office, 14600 South Ravinia Avenue, Orland Park, IL 60462.

Students - Earn Community Service Hours! /

We do not offer mandatory service hours. Must be 14 years of age.

I offer to volunteer my services to the Village of Orland Park and recognize that I will not be paid in any way. As a volunteer, parent, or

legal guardian of a volunteer I acknowledge that there are certain risks of physical injury to volunteers in their activities and I agree to

assume full risk of any and all injuries, damages or loss that I may sustain as a result of said participation. I do further agree to indemnify

and hold harmless the village, its trustee, officers, agents, and employees from any claim, suit, demand or liability being asserted at any

time in the future by the minor or on his/her behalf for any loss, costs or damages (including reasonable attorney’s fees and costs of

defense) resulting from the death, personal injury or property damage suffered by the minor resulting from the minor’s volunteer activities

as outlined above. Additionally I hereby give consent for the Village of Orland Park to use photos or video coverage of me and my minor

child/ward in future publications and promotions, and that these photos/videos remain the property of the Village of Orland Park.

Holiday Festival

|

November 26

|

3:00 p.m. to 8:00 p.m

.

|

Civic Center

Santa’s Pit Stop

|

December 2

|

9:00 a.m. to 12:00 p.m.

|

Sportsplex

Cinderella’s Ball

|

February 3

|

3:30 p.m. to 8:30 p.m.

|

Cultural Arts Center

Special Recreation Garage Sale

|

March 24

|

7:00 a.m. to 2:00 p.m.

|

Civic Center

Easter Egg Hunt

|

March 24

|

8:00 a.m. to 11:00 a.m.

|

Centennial Park

Special Recreation Norm Meyer’s Day

|

May 31

|

9:00 a.m. to 1:30 p.m.

|

153rd Street Metra Station

Theatre

|

Apr 26 - 29

|

Times Vary

Smart Living

|

Dates & Times Vary

I am willing to volunteer as needed.

Request for modification or assistance:

_____

Physical ability to lift up to 25 lbs.

_____ Able to stand for an hour or longer

Other

_________________________

Volunteer signature

________________________________________________________________

___________________

Date

Sr.