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Volunteer Application

TOWN OF DOVER 

RECREATION DEPARTMENT 

37 NORTH SUSSEX STREET 

DOVER, NEW JERSEY 07801 

Telephone: (973) 366-2200 xl 168 Fax: (973) 343-0188

Lisa Newkirk, Recreation Leader

Carolyn Blackman, Mayor

I hereby apply to perform public/volunteer services for community/recreation activities, events and programs. 

I agree to abide by all the rules and regulations set forth by the Department of Economic Development, Community Affairs and Recreation. I hereby release and hold harmless the Town of Dover from any and all claims but myself or my family or assignees which may arise from performance of the duties for which I' am volunteering and while traveling to and from said duties. 

By signing this application, I understand that I will be representing the Town of Dover and therefore agree to act and conduct myself in a professional manner at all times. I also understand that by not doing so can disqualify me from participating in future events and programs. 

PARENTS OPTIONS: 

I have read and understand this application and I give my child permission to be a volunteer for the Town of Dover. I accept full responsibility for my child's participation in the program; Additionally, I give permission for the Town of Dover to seek emergency medical attention in the event I'm am unable to give consent at the moment of the emergency for my child to receive the proper care. 



First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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