Name *

In the FIRST NAME field please type your first name then middle initial (John D. )

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birthday *

MM

DD

YYYY

Gender

Male

Female

Other

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Are you looking for volunteer opportunities for a group?

Yes

Are you fulfilling Court Ordered Community Service?

We can not accept community service applications if there are charges against people or theft in the last three years.

Yes

RELEASE OF LIABILITY

The undersigned individual will be engaged in volunteer service in the form of special events, warehouse, office and related duties for The Port Angeles Food Bank of Clallam County. This participation is voluntary on the part of the individual, who hereby releases The Port Angeles Food Bank, its managers, employees, agents, Board of Directors, predecessors, successors, assigns, representatives, attorneys, subsidiaries, and affiliates, and all persons acting by, through or in connection with any of them from any and all claims, liabilities, damages, losses, demands, and actions of any nature whatsoever arising out of the individual’s participation in such duties. Such release extends to any injury, damage, loss or liability incurred by the individual while engaged in such duties, whether occurring on or off the premises owned or operated by The Port Angeles Food Bank.

I agree to the release of liability as stated above

WSP BACKGROUND CHECK

I authorize the Port Angeles Food Bank to conduct a criminal records check. I understand that volunteering at the PAFB is contingent upon receipt of a satisfactory report.

I agree to a WSP background check