select
< April 2014 >
S M T W Th F S
  12345
6789101112
13141516171819
20212223242526
27282930   

Volunteer Agreement

Volunteer Agreement

The purpose of this Agreement is to outline the responsibilities of the City of Sammamish in providing volunteer opportunities, and to create an understanding between the City and the volunteer. The Agreement shall apply to persons voluntarily performing non-compensated services for the City.


First Name:
Last Name:
Primary Phone:           
Secondary Phone:           
Date of Birth:
Street Address:
City:
Zip Code:
Email:
Emergency Contact:
Emergency Contact Phone:
Is this for a court ordered community service?
What was your offense?
How many court ordered community service hours do you need?
Parent's or Guardian's Name:
Parent's or Guardian's Phone:
Parent's or Guardian's Email:

I understand that I will not be compensated for my work but volunteer to do so in a safe, responsible manner. I agree to abide by all relevant City policies and procedures. The City shall not be responsible for, nor liable for, nor shall the applicant be eligible to receive, any compensation or benefits as a result of this Agreement EXCEPT for State Labor and Industries Industrial Insurance medical aid coverage. If I decide to discontinue my volunteer service I will notify the City’s Volunteer Coordinator or supervisory City department staff.

Further, I certify that I am capable of performing the duties that are requested. If I am unable to perform the duties requested, I will immediately notify the Volunteer Coordinator or supervisory City department staff, so that either a suitable form of accommodation may be found, or that an individual who is capable of performing the task can complete it.

In consideration of the City of Sammamish giving me permission to perform these volunteer services, I understand and agree to the following terms:










By checking below, you grant the city permission to use any media generated at the volunteer event (optional).


By clicking the submit button, I agree that I have read and understand all terms listed in the Volunteer Agreement.