Adel Family Aquatic Center Application
City of Adel Parks & Recreation 301 S 10th St Adel, IA 50003 (515.993.4525) www.adeliowa.org
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Full Name: *
Street Address, City, State, Zip: *
Cell Phone Number: *
Email: *
Will you be at least 15 years of age by June 1st? *
Position: *
Required
Have you worked at the Adel Family Aquatic Center in the past? *
If yes, how many years and in what positions?
How many hours are you seeking to work per week? *
Please list all activities and dates (jobs/sports/vacations/etc.) that may conflict with your pool schedule: *
Where do/did you go to high school and what is your graduation year? *
If applicable, where do/did you go to college and what is your graduation year?
List any prior job experience (include employer, position, dates of employment, responsibilities, and reason for leaving). If this is your first formal job, please indicate that. *
List 3 references (include name, relationship, telephone number, email) *
Current Red Cross certifications (check all that apply) *
Required
If you have your Lifeguard/First Aid/CPR certification, what is the certificate ID number and expiration date?
If not currently certified or if your certification is set to expire this year, when and where are you planning/scheduled to get your initial or recertification?
List any additional trainings, certifications, or experiences related to the job you are applying for.
 **All lifeguards are expected to help with swimming lessons. Concessions and front desk may also assist if willing and capable.** What is your swimming background and what are your preferred levels to teach if applicable?
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all my statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.” *
Required
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