Volunteer With Us

First & Last Name

Email

Phone Number

Mailing Address

Preferred Pronouns

Date of birth (Month, Day, Year)

Emergency Contact’s First & Last Name

Emergency Contact’s Relationship To You

Emergency Contact’s Phone Number

What type of volunteer position interests you? (Select all that apply.) Event Support: duties include, but are not limited to, distributing materials and supplies, setting up and breaking down event spaces, registering attendees and providing information, and assisting with crowd management, walking one or more miles, and removing trash/debris from communities.

Community Outreach: duties include, but are not limited to, engaging with residents and organizations, distributing informational materials, and promoting events and initiatives.

What days are you available to volunteer? Please check all that apply.

Morning Monday Tuesday Wednesday Thursday Friday Saturday

Afternoon Monday Tuesday Wednesday Thursday Friday Saturday

Evening Monday Tuesday Wednesday Thursday Friday Saturday

What do you hope to gain from your volunteer experience?

I CERTIFY THAT I AM NOT AN EMPLOYEE OF THE COUNTY OF SAN DIEGO. * Check here

Please list any relevant skills or qualifications that you believe will help in your volunteer role (e.g., languages spoken, technical skills, certifications, able to lift heavy items, affiliations with non-profits or agencies etc.):

Do you have any medical or physical conditions we should be aware of to accommodate you during your volunteer work?

If yes, please explain:

I CERTIFY THAT THE INFORMATION PROVIDED IN THIS VOLUNTEER INTEREST FORM IS ACCURATE TO THE BEST OF MY KNOWLEDGE AND THAT ANY FALSE STATEMENTS OR ANSWERS WILL BE GROUNDS FOR DISQUALIFICATION. * Check here

I CERTIFY THAT THE SUBMISSION OF THIS VOLUNTEER INTEREST FORM DOES NOT GUARANTEE MY ADMISSION AND THAT I MUST WAIT TO START VOLUNTEERING AT THE DIRECTION OF COUNTY DISTRICT FOUR STAFF.. * Check here

I UNDERSTAND THAT ONCE I AM FORMALLY DESIGNATED AS A COUNTY OF SAN DIEGO VOLUNTEER, I AM SUBJECT TO ALL RULES AND REGULATIONS GOVERNING THE VOLUNTEER ACTIVITIES, AS SET FORTH BY THE COUNTY OF SAN DIEGO, INCLUDING THE SAN DIEGO COUNTY CODE OF ETHICS. * Check here

I AGREE AND UNDERSTAND THAT, IF SELECTED, ANY WORK I PERFORM WILL BE PROVIDED ON A VOLUNTARY BASIS, AND THAT I DO NOT EXPECT PAYMENT OR OTHER COMPENSATION FOR PERFORMING SUCH WORK. I ALSO UNDERSTAND THAT A VOLUNTEER POSITION DOES NOT CONSTITUTE AN EMPLOYEE-EMPLOYER RELATIONSHIP WITH THE COUNTY OF SAN DIEGO, AND THAT I SERVE AT THE DISCRETION OF THE COUNTY DISTRICT FOUR STAFF. * Check here

I CERTIFY THAT I VOLUNTARILY CHOOSE TO PARTICIPATE IN THE COUNTY DISTRICT FOUR VOLUNTEER PROGRAM AND AM FULLY AWARE OF THE POTENTIAL RISKS INVOLVED WITH THE VOLUNTEER ACTIVITIES DESCRIBED IN QUESTION 10 ABOVE. I HEREBY WAIVE THE COUNTY OF SAN DIEGO AND ITS EMPLOYEES FROM ANY AND ALL LIABILITIES, CLAIMS, OR CAUSES OF ACTION THAT MAY ARISE FROM INJURY, LOSS, OR DAMAGE THAT OCCURS DURING MY PARTICIPATION AS A VOLUNTEER WITH THE COUNTY OF SAN DIEGO DISTRICT FOUR OFFICE. * Check here

I UNDERSTAND THAT BY CHECKING THE BOX, I AM WAIVING CERTAIN LEGAL RIGHTS AND AGREEING TO HOLD THE COUNTY OF SAN DIEGO, ITS OFFICERS, AGENTS, AND EMPLOYEES HARMLESS FROM AND AGAINST ALL CLAIMS, DEMANDS, COSTS, EXPENSES, OR OTHER LIABILITIES ARISING OUT OF MY PARTICIPATION AS A VOLUNTEER WITH THE COUNTY OF SAN DIEGO DISTRICT FOUR OFFICE. * Check here

I HEREBY AUTHORIZE THE COUNTY OF SAN DIEGO TO COPYRIGHT, PUBLISH, USE, SELL OR ASSIGN ANY AND ALL PHOTOGRAPHIC PORTRAITS OR PICTURES, TELEVISION SPOTS, MOVIE FILMS, VIDEOTAPES, AND/OR SOUND RECORDINGS, OR ANY PART THEREOF, THE COUNTY MAY HAVE TAKEN OR MADE OF ME OR IN WHICH I MAY BE INCLUDED IN WHOLE OR IN PART. * Check here

I CERTIFY THAT I AM NOT AN EMPLOYEE OF THE COUNTY OF SAN DIEGO. * Check here

Supervisor Monica Montgomery Steppe

San Diego County | District 4

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