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Board(s) desired by preference (see the relevant board / commission page for description):
As an applicant for an appointment on a Maitland City Board(s), Commission(s), or Committee(s) with the City of Maitland, I am willing to furnish information for use in determining my qualifications. In this connection, I authorize release of any and all information that may be available concerning me, including information of a confidential or privileged nature.
I hereby release you, the City of Maitland and others from liability or damage which may result from furnishing the information requested.
As a volunteer for the City of Maitland, I understand that I am not eligible for compensation or benefits for services rendered.
In consideration of the permission granted me by the City of Maitland, to participate as a volunteer to and within the City and any and all activities or events related to this volunteer appointment, I the Undersigned for myself, my heirs, assigns and administrators, Hereby release, waive and forever discharge the City of Maitland and its agents, officers and employees from all liability to the Undersigned, my heirs, assigns and administrators, of and from all claims and demands, actions and causes of action of any kind (inclusive of claims for personal injuries and property damage), damages, losses and liabilities, costs, expenses and unknown, foreseen and unforeseen damages and consequences thereof, caused by or arising out of my participation in any volunteer appointment.
I certify and warrant that I am in good physical condition and am able to participate as a volunteer in the agreed upon volunteer appointment and any and all activities or events related to this volunteer appointment, and do agree to do so at my own risk.
I expressly agree and acknowledge that my participation in any above referenced activity or event is as a volunteer and not as an employee of the City of Maitland and that I understand and agree that I shall not accrue nor shall I be entitled to any City employee benefits, wages or other incidents of employment by virtue of this agreement, except any workers' compensation benefits to which the volunteer may be entitled to under Florida Workers' Compensation law.
I have carefully read the foregoing release and waiver and know the contents thereof and have signed this release and waiver as my own free act.
This Release and Waiver contains the entire agreement between the Undersigned and the City of Maitland and the terms of this Release and Waiver are contractual and not a mere recital. I expressly agree that this Release and Waiver is intended to be as broad and as inclusive as permitted by the laws of the State of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding continue in full force and effect.
City of Maitland drug-free workplace I freely and voluntarily agree to submit to a drug test as part of my application when required by the City.
I further understand that upon commencement of volunteering with the City of Maitland I may be required to submit to a drug test as a result of sustaining a post work injury requiring medical attention beyond the Fire Department's first aid treatment. I also understand that my refusal to take a requested drug test or my failure to meet the minimum standards set for the screening may result in immediate dismissal.
The following is a list of all drugs for which the City of Maitland will test the volunteer, if tested: Alcohol; Amphetamines; Cannabinoids; Cocaine; Phencyclidine; Methaqualone; Opiates; Barbiturates; Benzodiazpines Synthetic narcotics; Methadone and Propoxyphene.
All information is confidential and all results are discussed with the Volunteer Member prior to any communication with the City.
I have read in full and understand the above drug-free workplace statements and conditions of volunteering.
This field is not part of the form submission.
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