Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Highest Level of Education

High School

Associate's Degree

Bachelor's Degree

Master's Degree

Other

Availability

When are you available for volunteer assignments?

Weekday mornings

Weekday afternoons

Weekend mornings

Weekend afternoons

Please specifiy

List specific days of the week and times if known.

Interests

Please explain your interest in a volunteer position at Waimea Valley:

Volunteer Interests

Please check the areas in which you are interested in volunteering:

Botanical gardens

Cultural sites

Conservation

Greeter at Visitor Center

Interpreter/Docent

Administrative/Office

Special events

Internship

Hiking experience

If interested in conservation work, please tell us how often you go hiking?

I have never hiked before

I go hiking on occasion (a few times per year)

go hiking on a regular basis (once a month)

I live to hike

Special Skills or Qualifications

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Experience

Summarize your previous volunteer experience.

Emergency Contact

Name of emergency contact.

First Name

Last Name

Phone number of emergency contact

(###)

###

####

Email of emergency contact

Agreement

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Electronic signature

First Name

Last Name

Date

YYYY

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Volunteer Background Check Authorization

I authorize Hi`ipaka, LLC and its agents, assignees, employees or officers to make investigations, reference checks, security checks and other inquiries into my past regarding my Volunteer application. These queries may include, but are not limited to, questions pertaining to my past employment, criminal, credit, driving and educational history as well as information regarding my general character and reputation. Further, I authorize any individual, company, business entity, institution, or government agency having relevant information to furnish Hi`ipaka, LLC with that information. I agree to release and hold harmless the Hi`ipaka, LLC from any and all liability with respect to receipt of such information and acknowledge that Hi`ipaka, LLC is relying on third party information and therefore release Hi`ipaka LLC, its agents, officers, and employees from any and all liability arising out of errors or omissions. I understand that the information I provide on this form will be used solely by Hi`ipaka, LLC in obtaining background information to determine volunteer eligibility. It will not be used to discriminate or determine eligibility based upon gender, age, race, color, creed, national origin, disability, veteran, marital status or any other category protected by law. You are not required to report your sex or race and providing that information is strictly voluntary. Not reporting that information may lengthen the time that it takes to process your background check but will not exclude you from volunteer eligibility.

Name

First Name

Last Name

Date of Birth

YYYY

Age

Gender

Volunteer Release, Waiver and Consent

I wish to participate in volunteer services and activities in Waimea Valley to help promote Hi‘ipaka LLC’s mission. I understand and agree that my participation in these services and activities will be on a strictly voluntary basis, and that I will not receive any money or other compensation for participating in them. I understand and agree that in acting as a volunteer, I am not an employee, representative or agent of and have no position or other capacity with Hi‘ipaka LLC except as a volunteer. I am in good physical condition and can work self-sufficiently without assistance. Prior to my participation in any volunteer activities in Waimea Valley or for Hi‘ipaka LLC, I will inform Hi‘ipaka LLC of any mental, physical, emotional and/or medical conditions that may create or increase a risk of harm to myself or others while engaging in any activities proposed herein or assigned to me as a volunteer, including but not limited to lifting, weeding, plant trimming, or painting. I will not undertake any activity that I believe will pose a risk of harm or injury to myself or others. I understand I should wear proper footwear with good traction, should have clothing suitable for work in rainy, wet, slippery and/or windy conditions as well as hot and/or dry conditions, and should provide my own sun protection and water. I will be responsible for my own equipment and supplies, if any, and for the safe use and proper care of my or Hi‘ipaka LLC’s equipment and supplies. I acknowledge that there are inherent risks and dangers associated with my volunteer activities in Waimea Valley, including, but limited to, the risks of injury, death or loss from the use of tools or equipment, from walking on uneven ground and/or slippery rocks, and from heavy rains and flooding. I hereby assume all risks and dangers in participating in volunteer activities in Waimea Valley, and hereby knowingly waive, release, discharge and agree to hold harmless and indemnify Hi‘ipaka LLC, Hi‘ilei Aloha LLC, and OHA, and their respective members, managers, Trustees, employees, agents, affiliates, successors and assigns from any and all claims for personal injury, death or property damage of any kind or nature whatsoever arising out of or in the course of my participation in volunteer activities in Waimea Valley and/or for Hi‘ipaka LLC. In addition, I hereby consent to Hi‘ipaka LLC, Hi‘ilei Aloha LLC, and OHA or persons authorized by any of them to use photographs, videotapes, motion pictures, audio recordings, or any other record of my participation in volunteer activities in Waimea Valley and/or for Hi`ipaka LLC for any lawful purpose, without liability to said entities and persons, and I understand that I will not be entitled to any compensation for the use thereof. If the volunteer is a minor, I represent to Hi‘ipaka that I am the parent or other legal guardian of the minor lawfully authorized to sign this form on behalf of said minor, and that my signature constitutes my agreement, as said minor’s parent or legal guardian, to the terms, covenants and representations above on behalf of said minor. I further agree that I shall be solely responsible for the care and supervision of said minor and for said minor’s conduct while he or she is in Waimea Valley.

Signature of Volunteer (or minor's guardian)

First Name

Last Name

Date

YYYY

Mahalo nui loa for submitting your application. You will be contacted soon. For any questions please email volunteers@waimeavalley.net

Volunteer Application

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