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* 1. Legal Name (only used by the Grand Rapids Pride Center for background check)

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* 2. Chosen Name

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* 3. Birth Date- Must be 18 or older to volunteer. Only 21+ in the beer tents. Must show ID when checking in.
(Those who are 13 - 17 are encouraged to contact the GRPC to find out how to get connected with the youth group.)

Date

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* 4. Legal Sex (only used by the Grand Rapids Pride Center for background check)

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* 5. Pronouns:

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* 6. If your pronouns were not listed, would you please tell us what they are?

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* 7. Phone:

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* 8. Email:

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* 9. I am fluent in the following languages:

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* 10. Do you need any special accommodations?:

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* 11. On Saturday I would like to volunteer with:

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* 12. Are you open to more than one 4hr shift?:

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* 13. T-shirt Size:

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* 14. Volunteer Confidentiality Agreement and Release of Liability: Confidentiality Respectful and strict confidentiality is expected of all volunteers. All observed or communicated information, whether obtained formally or informal, is to be considered completely confidential - even if it seems public or unrelated to GRPC. Names and identities of members are also confidential. By participating as a volunteer, I agree to respect the privacy of other volunteers, staff, and members and to not disclose anything that is discussed during hours of service, before or after hours of service, or during breaks from hours of service. If at any time I violate the confidentiality of another volunteer or member, I understand that my participation with GRPC is terminated and I will face the full legal consequences of my actions up to, and including, fines and imprisonment. Release of Liability I hereby release GRPC, agents of GRPC, and members, from any and all liability for real or perceived physical, mental, or emotional harm incurred before or after, during travel to or from, during breaks of, or during, the hours of service. In consideration of my participation in any and all events of GRPC, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages, demands, actions whatsoever in any manner, as a result of participation in any activities/events including travel to and from events. By completing this form and submitting the information below, I agree to the conditions herein:

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* 15. Background Check: I hereby authorize Grand Rapids Pride Center (GRPC) bearing a copy of this release, at anytime during my participation as a volunteer to run a background check. I understand that at a minimum the GRPC will run the background check once a calendar year. GRPC may obtain any information pertaining to my criminal history from local, state or federal agencies as necessary to ensure the safety of GRPC, it's staff or others in the community. , This release is executed with the full knowledge and understanding that the information is for the official use of GRPC. Consent is granted for GRPC to furnish such information, as directed above to third parties in the course of fulfilling its official responsibilities. I hereby release GRPC and any agencies needed to obtain this information from any and all liability for damages of whatever kind, which may at the time result to me, my heirs, family or associates because of my compliance with this authorization and request to release information, or any attempt to comply with it:

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* 16. Media Release: I acknowledge that my participation is completely voluntary. I understand that by participating in volunteer activities with Grand Rapids Pride Center (GRPC) I may be recorded on video and/or audio tape and such recordings may be broadcast on television, radio, or via the internet, and I give my consent. I understand that by participating I may be photographed or quoted and that such photos or quotations may be published in a newspaper, a magazine, a publication of the GRPC, or on the internet, and I give my consent. I agree to release GRPC staff, agents, contractors, and programs from any liability associated with the broadcast of video or audio tape recordings or publication of photographs of my participation in volunteer activities for GRPC:

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* 17. Agreement certifying that the above information is true and correct.:

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* 18. Please type your full legal name and the date you are submitting this application on as your electronic signature:

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* 19. May we add you to our email list? Emails and contact information are kept confidential and are for in-house use only. They are never shared with 3rd parties:

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