2011 u.s figure skating championships volunteerapplication_003

Upload: an-cosm

Post on 10-Apr-2018

219 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/8/2019 2011 U.S Figure Skating Championships VolunteerApplication_003

    1/3

    2011 U.S. Figure Skating

    Championships

    VOLUNTEER APPLICATION

    January 22-30, 2011Please print clearly. Only one applicant per form.This form can be copied.

    Name: ____________________________________________________ Date of Birth ____/____/_______ Male / Female (circle oneFirst Middle Last

    Address: ________________________________________________ City ________________________ State ______ Zip ___________

    Daytime Phone: ____________________ Evening/Cell Phone: _______________________ Fax #: ______________________________

    Email: ________________________________________Occupation: _______________________ Employer: ______________________

    Volunteers must commit to a minimum of 24 hours (four 6-hour shifts) There will be a mandatory training session in December 2010 Volunteers must be able to work between Thursday, January 20 and Monday, January 31 Dates, times, and areas to work are requests only. There is no guarantee they will be met.

    ____ Please check here if you have purchased All-Event Tickets. All-Event ticket purchasers will be given priority for choice of hours

    to assure that you can watch the events you choose.

    Please select your tee shirt size. ____S ____M ____L ____XL ____XXL

    Day Thurs. 1/20 Fri. 1/21 Sat. 1/22 Sun. 1/23 Mon. 1/24 Tues. 1/25 Wed. 1/26 Thurs. 1/27 Fri. 1/28 Sat. 1/29 Sun. 1/30 Mon. 1

    6am-12pm

    12pm-6pm

    6pm-12am

    Indicate with an X when you are available. At least 4 shifts must be selected. There are limited opportunities available on 1/20, 1/21, and 1so please do not select only those dates for your volunteering.

    OLUNTEER ASSIGNMENTS: Mark the area in which you are most interested by putting 1, 2, or 3 next to the area, with 1 being first pref

    __ Registration (need computer experience) __ Hospitality/Special Events __ Credential Monitor

    __ Greeter/Information/Transportation (local resident) __ Communications/Copy Center __ FanFest

    __ Competition Services __ Office Services/Volunteer Support __ Media Services

    __ Operations/Event Set-Up & Tear Down __ Wherever Needed

    List previous figure skating and/or event volunteer experience:

    List your skills and/or expertise (such as computers, hospitality) in a particular field:

    ___ (Check if applicable) I am a North Carolina resident interested in volunteering for opportunities to promote the 2011 U.S. Figure Skati

    Championships in advance at festivals, Coliseum events, trade shows, etc.

    Page 1/3

    Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 2

    return by 10/31/2010 by fax: 919-678-1655

    For Office Use Only:

    ____ Application (pages 1-2) Received____ Security Check Release Received____ Security Check Complete____ Confirmation Sent

    Committee Assignment: ________________

    Official Volunteers Sponsor

  • 8/8/2019 2011 U.S Figure Skating Championships VolunteerApplication_003

    2/3

    2011 U.S. Figure Skating Championships

    VOLUNTEER APPLICATION

    January 22-30, 2011Please print clearly. Only one applicant per form. This form can be copied.Volunteers must be 18 years of age by December 1, 2010

    IN CASE OF EMERGENCY, PLEASE NOTIFY:

    Name: __________________________________________________ Relationship to You: __________________________________

    Daytime Phone: ____________________________ Evening Phone: ___________________________

    Selection & Discharge of Volunteers: It is possible that we will receive more volunteer applications than positions available. Therefore, submitting avolunteer application does not mean that you will be selected as a volunteer. The selection of volunteers from among the qual ified applicants is at thesole discretion of NC 2011 and U.S. Figure Skating and is not subject to appeal and dispute. No reason need be given for the refusal of an applicant.Volunteers will not be selected or rejected on the basis of race, color, national origin, sex, sexual orientation, marital status or age. Persons withdisabilities must be able to perform the essential functions of the volunteer position for which they are selected; however, persons with disabilities canperform the essential functions of most volunteer positions. Acceptance as a volunteer creates no rights to compensation or continued service.Volunteers serve at the pleasure of the 2011 U.S. Figure Skating Championships and U.S. Figure Skating. NC 2011 and U.S. Figure Skating reserve th

    right to terminate the service of any volunteer and to reclaim the volunteer credential issued. Termination is at the sole discretion of NC 2011 and U.S.Figure Skating and is not subject to appeal or dispute.

    THE FOLLOWING RELEASE MUST BE READ AND SIGNED TO COMPLETE THIS APPLICATION:

    In consideration of being permitted to participate in the 2011 U.S. Figure Skating Championships, and in voluntary recognition and as-sumption of any risk and hazard associated with my participation, I _____________________________, for myself, and heirs, personarepresentatives, successors and assigns, hereby voluntarily release and hold harmless U.S. Figure Skating, North Carolina 2011,Sports & Properties, Inc., and the Greensboro Coliseum Complex, and each of their officers, trustees, boards, committees, employees,agents, participants, and representatives, and all other entities or parties associated with the 2011 U.S. Figure Skating Championships(collectively, the Released Entities) from any and all claims, losses, damages and liabilities arising from death, injury, illness or damagincurred or suffered by me or any other person arising out of, relating to, or resulting from my participation in the 2011 U.S. Figure Ska

    ing Championships and related incidental activities including pre-event set-up and post-event tear down activities. I also approve theuse of my picture, likeness, or voice for promotional use, regardless of whether the picture, likeness or voice was recorded before, dur-ing or after the 2011 U.S. Figure Skating Championships in any medium.

    I also acknowledge that I have been informed that I may be required to provide a set of impressions of my fingerprints and that acriminal history records check may be performed to determine my eligibility to serve as a volunteer for the 2011 U.S. Figure SkatingChampionships. I acknowledge that I have received, read, and understand the Consent for Criminal History Records Check that accompanies this application. I understand that I may be ineligible to volunteer based on the results of the criminal history recordscheck. I acknowledge that the scope of this Release includes any conduct by the Release Entities related in any way to the criminalhistory records check and its results, including any decision to deny my Volunteer Application.

    _____________________________________________________________________________________/__ /________________SIGNATURE OF APPLICANT DATE

    Page 2/3

    Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 2

    return by 10/31/2010 by fax: 919-678-1655

    VOLUNTEER APPRECIATION PACKAGE:

    Official Volunteer Commemorative Uniform to be worn during volunteer shift Complimentary Volunteer Parking (with shuttle service to Greensboro Coliseum Complex) Refreshments while volunteering Complimentary access to practice viewing

    Ticket purchase discounts

    Your Name: __________________________________________________

    PRESENTED LOCALLY BY:

  • 8/8/2019 2011 U.S Figure Skating Championships VolunteerApplication_003

    3/3

    Consent for Criminal History Records Check

    hereby give my permission to U.S. Figure Skating and North Carolina 2011 to obtain information relating to my criminal historecord through a reporting agency that regularly performs background checks. I understand that I may be required to provide set of my fingerprint impressions for the records check to be completed. If I am not required to provide fingerprint impressionsunderstand that the records check will be conducted based on my social security number. The criminal history record, as re-ceived from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudicationand delinquent conduct committed as a juvenile. I understand that this information will be used, in part, to determine my eligibty for a volunteer position at the 2011 U.S. Figure Skating Championships. I also understand that the criminal history could cotain information presumed to be expunged.

    , the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release and forever discharge andagree to indemnify and hold U.S. Figure Skating and North Carolina 2011 and the organization performing the backgroundcheck and each of their respective officers, directors, employees, and agents harmless from and against any and all causes of

    actions, suits, liabilities, costs, debts, and sums of money, claims and demands whatsoever (including claims for negligence,gross negligence, and/or strict liability of U.S. Figure Skating and North Carolina 2011 and the organization performing thebackground check) and any and all related attorneys fees, court costs and other expenses resulting from the investigation of my background in connection with my application to become a volunteer for the 2011 U.S. Figure Skating Championships.

    further authorize U.S. Figure Skating and North Carolina 2011 to check my criminal history records with any or all local,county, state, and federal agencies and records departments as part of my association as a volunteer for the 2011 U.S. FigureSkating Championships.

    __________________________________________ _____________________________________________Volunteer Signature Drivers License Number/State

    __________________________________________ _____________________________________________Volunteer Name (Print) Social Security Number

    __________________________________________ _____________________________________________Date Date of Birth Gender

    __________________________________________ _____________________________________________City/State of Birth List all States of residence in the past 5 years

    Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 2

    return by 10/31/2010 by fax: 919-678-1655

    Page 3/3