Mead Public Library Application and Waiver of Liability

Volunteers 14 – 17 years old Name___________________________________________________ Date of Birth_______________________ Address___________________________________________________________________________________ City & State______________________________________________________ Zip Code___________________ Home Phone (_______) _____________________

Cell Phone (_______) ______________________

E-Mail_____________________________________________________________________________________

Parental Consent and Waiver of Liability Volunteers increase the library’s capacity to provide service to Sheboygan area residents without great increases to expenditures. In addition to managing its expenditure in the best interest of Sheboygan residents, the library must manage its risk. As a volunteer, you agree to indemnify, defend and hold harmless and release Mead Public Library, City of Sheboygan, Mead Public Library Foundation, Inc., Friends of Mead Public Library and their elected and appointed officials, officers, employees and authorized representatives from and against any and all liability, loss, damage, expenses, costs (including attorney’s fees) arising out of or in any way attributed to the volunteer activities performed whether on or off library premises. By signing this agreement, you acknowledge that you and your minor child have read it in its entirety, have given the terms due consideration, understand the terms, and understand that you and your child are freely and voluntarily giving up certain rights. As a parent or guardian, your signature further indicates that you acknowledge that this agreement shall be binding upon all of your and your child’s successors, heirs, assigns, receivers and the like. Parent or Legal Guardian___________________________________________ Date_______/_____/________ (Print)

Parent or Legal Guardian___________________________________________________________ (Signature)

Your signature below indicates your approval to allow Mead Public Library designee to contact references or employers of your minor child related to service as a library volunteer. Parent or Legal Guardian___________________________________________ Date_______/_____/________ (Signature)

References and/or Employer Name 1.______________________

Relationship/Company ___________________________

Telephone Number _______________________

2.______________________

___________________________

_______________________

In case of emergency contact: Name 1.______________________

Relationship ___________________________

Telephone Number _______________________

2.______________________

___________________________

_______________________

Area of interest (please indicate preferences): ______Verifying and straitening books ______Computer training ______Homebound delivery program ______Special events ______Maas Teen Learning Center Monitor

______Locating reserved books/items ______Makerspace ______Drop-in session facilitator ______Training (Please list expertise) ________________________

Availability: Is this a requirement for community/work/school?_______ Number of hours required_____ To be completed by ____/_____/________ Please indicate times available Day/Time Sunday Monday A.M. P.M.

Tuesday

Wednesday Thursday

Friday

Saturday

_____________________________________________________________________________ Original forms are filed in the Volunteer Services office. Please drop off this form at our first floor Customer Service desk, or mail/email to: Volunteer Services Mead Public Library 710 North 8 Street Sheboygan, WI 53081 459-3400, Ext. 3411 [email protected]

MEAD PUBLIC LIBRARY VOLUNTEER PROGRAM Thank you for your interest in volunteering with the Mead Public Library! We welcome the opportunity to recruit library volunteers for a number of activities throughout the year, and we are excited to get to know you and work with you. QUALIFICATIONS Mead Public Library Volunteer Program is open to men and women from 14 years of age or older who are interested in offering their free time, on a regular basis, to assist in any number of tasks which are key to the facilitation of operations and the wellbeing of the library. Library Volunteers must be able to meet the following basic criteria in order to participate: 1. Weekly commitment of time on a regular ongoing basis. 2. Attendance of a mandatory orientation session. 3. All volunteers age 18 years or older may be subject to a background check. 4. Some tasks require physical abilities including frequent and extended periods of walking, stooping, bending, squatting, kneeling and standing on floor; lifting, pushing and carrying objects of moderate to heavy weight (up to 50 lbs.). 5. Ability to use online catalog and find items on the shelf using call number tags. Library Volunteers are a tremendous asset to the library and library staff members. They work alongside of and in conjunction with employees to ensure that library activities flow smoothly and effortlessly. Their enthusiasm and contribution go far in their interest in assisting the library. Thus considerations to those who maintain a corporative, friendly and courteous disposition are highly probable candidates.

Please fill out the attached form in its entirety and return via fax, email, or drop off to: Volunteer Services Mead Public Library 710 North 8 Street Sheboygan, WI 53081 459-3400, Ext. 3411 [email protected]

Once you have submitted your application, please allow 48 hours for a response with further instructions.