Berlin-Peck Memorial Library Teen Volunteer Application
Please complete this form below to apply to become a volunteer at the Berlin-Peck Memorial Library. Once your application has been received you will be notified when volunteer opportunities are available. Thank you!

Please contact the Berlin-Peck Children's/Teen staff at kids.bpml@gmail.com or (860) 828-7127 with any questions!
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Age *
Grade *
Parent Phone Number *
Volunteer Phone Number (Optional)
Address and City *
Email (We will send notifications and instructions  for signing up for volunteer shifts to this email) *
Emergency Contact Name (First & Last) *
Emergency Contact Phone Number *
Emergency Contact Relationship (parent, guardian, etc.) *
Hold Harmless Agreement: I release, hold harmless, for myself and for my heirs, assigns, successors, executors, administrators, and legal representatives, agree that I will not sue the Town of Berlin, or its agents, servants, or employees, from or regarding any injury or loss to person or property, including wrongful death or emotional injury, that I may sustain while performing volunteer work for the Town of Berlin or its agents, servants or employees. I do understand that if I am injured while performing assigned work I will report it immediately, but as I am not an employee of the Town of Berlin I have no right to claim a worker's compensation injury. Further, that I will be responsible for any medical bills should I become injured. I also know that if I am given a task and I am not familiar with a piece of equipment that I will ask for training in its use, or, that I can decline to use the piece of equipment, such as a power tool. By my use of the tool I state that I know how to use it safely and properly.    Agreement of Applicant (First & Last Name) *
Type your first and last name on the line below:
Agreement of Parent/Guardian if Applicant is under 18 (First & Last Name) *
Type your first and last name on the line below:
Why would you like to volunteer at the Berlin-Peck Memorial Library? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms