Missouri City Online Forms

2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. Subdivision*
11. Phone*
12. Email*
14. City*
15. State*
16. Zip*
18. Date of Birth *
    Date of Birth
20. Emergency Contact Name*
21. Emergency Contact Number*
25. Please let us know your volunteer interests.
27. What volunteer opportunities interest you? *
    If interested in a specific department or volunteer position, please specify.
29. Please list any previous volunteer experience you have*
31. Do you have any special skills or training? *
33. Do you speak or write a language other than English?*

    1. Yes

    1. No
35. Please explain your level of proficiency (Native/Fluent, Advanced, Intermediate or Basic)*
37. What is your purpose for volunteering?*
39. Do you have any restrictions or limitations for service? (i.e., health concerns, allergies, etc.)*
41. When will you be available to volunteer? *

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday

    1. Friday
    2. Saturday
    3. Sunday

    Please check all that apply

45. Please list two individuals we may contact as character references.

47. Reference 1
49. First Name*
50. Last Name*
52. Phone*
53. Relationship *
55. Reference 2
57. First Name*
58. Last Name*
60. Phone*
61. Relationship *
63. Have you ever been convicted, pled guilty or no contest, or placed on deferred adjudication or probation for any offense other than traffic violations? If yes, please provide details including charges, penalties, where, when, and disposition.*

    1. Not sure

    1. Yes

    1. No
65. Please provide details below*
67. Have you ever worked or volunteered for the City of Missouri City, Texas?*

    1. Not sure

    1. Yes

    1. No
69. Please provide details below*
71. Are you related to anyone working for the City of Missouri City?*

    1. Yes

    1. No
73. Please provide details below*
77. Volunteer Activity Waiver
    If authorized to participate in the City of Missouri City Municipal Volunteer Program, for and in exchange for my being allowed to volunteer with the City I, being 18 years of age or older, agree to the following:
    
    1. Terms and Agreements
    
    I agree to adhere to the policies and procedures of the City of Missouri City (“City”), including, but not limited to, the City of Missouri City Municipal Volunteer Program Manual, and to abide by the directives and instructions given to me by the City’s officers, employees and agents. I understand and agree that serving as a volunteer for the City is a privilege granted by the City, and not a right, and that such privilege may be discontinued at any time without cause or recourse.
    
    I understand and agree that I am not considered an employee or officer, nor am I an employee or officer, of the City and will not be provided with compensation or benefits of any kind. I recognize and agree that the City has not made any representations as to the safety of the volunteer activities that I may perform. I acknowledge that within the course and scope of my activities as a volunteer, I may be exposed to hazards or risks that may result in my illness, personal injury, or death and I understand and appreciate the nature of such hazards and risks. By agreeing to these terms, I voluntarily and knowingly assume all risks, both known and unknown, and full responsibility for all injuries, death, and property damages arising out of, or in any way associated with, my volunteer activities.
    
    I understand that during my volunteering activities or related activities, I may be recorded, photographed or videotaped. I agree to allow any record, including, but not limited to, photographs, video and film, of my likeness to be used by the City at any time and for any purpose.
    
    2. Waiver, Release, and Indemnification
    
    I do hereby voluntarily and knowingly release, waive, forever discharge and covenant not to sue the City, its officers, employees, contractors, subcontractors, and agents, in both their individual and official capacities, from any and all liability, claims, demands, damages, awards, judgments, costs, actions, compensation, reimbursement, causes of action or suit of any kind or character, present and future, known and unknown, on behalf of myself, my personal representatives, estate, assigns, heirs, administrators, and next of kin for any and all loss or damage, claims, demands, or causes of action on account of personal injury, death, or damage to my property arising out of or related to my volunteering activities, WHETHER CAUSED BY THE NEGLIGENCE OR ACTS OR OMISSIONS OF THE CITY, ITS OFFICERS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, OR AGENTS. I do hereby indemnify, hold and save harmless the City, its officers, employees, officers, agents and all others who may be liable, present and future, known or unknown, from any and all causes of action resulting in damage to my property or to my person, or for personal injuries or death sustained by me while volunteering including, but not limited to, damage, injury or death caused by the negligence or acts or omissions of the City, its employees, officers, contractors, subcontractors, or agents.
    
    I FURTHER AGREE TO DEFEND, INDEMNIFY, AND HOLD HARMLESS THE CITY, ITS EMPLOYEES, OFFICERS, CONTRACTORS, SUBCONTRACTORS, AND AGENTS, IN BOTH THEIR INDIVIDUAL AND OFFICIAL CAPACITIES, FROM AND AGAINST ANY AND ALL ACTIONS, CAUSES OF ACTION, CLAIMS, OR DEMANDS OF EVERY KIND AND CHARACTER, INCLUDING, BUT NOT LIMITED TO, ATTORNEY’S FEES, AWARDS, COMPENSATION, COSTS, DAMAGES, EXPENSES, JUDGMENTS, LIABILITIES, REIMBURSEMENT, AND SUITS WHICH MAY BE ASSERTED BY ANY PARTY FOR ANY REASON OR CAUSE, INCLUDING, BUT NOT LIMITED TO, PERSONAL INJURY, INCLUDING DEATH, PROPERTY DAMAGE OR LOSS, OR THE EFFECTS OR CONSEQUENCES THEREOF THAT ARISE OR MAY ARISE FROM MY NEGLIGENT OR INTENTIONAL ACT OR OMISSION WHILE ACTING AS A VOLUNTEER REGARDLESS OF WHETHER CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE ACTS OR OMISSIONS OF THE CITY, ITS EMPLOYEES, OFFICERS, CONTRACTORS, SUBCONTRACTORS, AND AGENTS, IN BOTH THEIR INDIVIDUAL AND OFFICIAL CAPACITIES.
    
    I agree that in the event any action is brought against the CITY, its employees, officers, contractors, subcontractors, or agents, in either their individual or official capacities, and its assigns and successors, collectively or individually, pursuant to any claims released herein, that a presentation of this Volunteer Activity Waiver shall constitute a complete and affirmative defense to said claim, and that a court of competent jurisdiction may dismiss said claim with prejudice.
    
    I agree that this Volunteer Activity Waiver extends to all acts of the CITY, its employees, officers, contractors, subcontractors, or agents, including negligent acts and omissions, and that this Agreement, is intended to be as broad and inclusive as is permitted under the laws of the State of Texas and if any portion herein is invalid, I agree that the remainder shall continue in legal force and effect.
    
    I agree that this Volunteer Activity Waiver and the terms contained herein shall survive the expiration or termination of my volunteer activities.
    
    3. By typing my name below, I certify, authorize, or acknowledge: That all the information provided by me on this application for volunteering and any attachments or supporting documents I submit are accurate. Recognizing that the City may rely upon information I provide to make decisions on volunteers, I hereby certify that all information herein presented is accurate and free from omission, falsification, or misleading information. I authorize the City of Missouri City to conduct background, personal, criminal, employment, volunteer history, or any type of investigation it may require to determine my fitness for volunteering. Convictions from a criminal background check will not necessarily disqualify an applicant for volunteer opportunities. Additionally, I understand that the City may require a physical examination, including, but not limited to, a drug screening.
79. First Name*
80. Last Name*
82. Parent/Guardian First Name
    If applicant is under the age of 18
83. Parent/Guardian Last Name
85. Date*
    Date
    Please enter today's date
Leave This Blank:


87. 1. Receive an email copy of this form.
88. Email address

    This field is not part of the form submission.

89. Submit

* indicates a required field