Volunteer Service Statement & Agreement 2008-2009
I make this statement and agreement in order to provide, and to be authorized to perform, the following
uncompensated services to my community.
I _______________________________ intend to volunteer in the school, work at PTA functions, and/or
chaperone field trips under the direction of the Northwood School Administration between the dates of July 1,
2008 and June 30, 2009.
1. That I am 18 years of age or older and know of no reason, medical or otherwise, that would prevent
me from performing the tasks required;
2. That I have acquainted myself with the requirements necessary to perform these tasks and that I have
the skill and ability to perform them;
3. That I assume full responsibility for my own safety and the safety of others and, except where
resulting from negligence of the Northwood School District or its employees, I release and hold harmless the
Northwood School and its agents, employees, and officers from any and all claims of any nature for any illness
or personal injury to me or any damage to any property arising from my participation in the above described
activity. I further acknowledge that this release is binding upon my heirs, successors, or assigns; that I have
read the foregoing and understand its significance; and that I have executed this document voluntarily;
4. That I will perform the volunteer service in compliance with the standards and specifications
established, or approved, by the Northwood School District and I will honor the direction of the Northwood
School District officials to suspend or terminate service.
Northwood School Confidentiality Statement 2008-2009
We are required to ensure the confidentiality of personally identifiable information of all students.
I agree to treat as confidential all particular information or special knowledge, regarding any student,
learned while visiting or working at the Northwood School. This includes the nature of services rendered, as
well as any personal information.
I acknowledge that it is my permanent duty never to divulge information regarding students. This
includes observations made in the school, information heard in the in the office or from teachers and/or staff, or
information seen on papers or in student records.
Volunteer Registration Form 2008-2009
We welcome your participation in the Northwood School Volunteer Program. The Volunteer Program
encompasses all areas of parent volunteerism. This includes chaperones and in-school volunteers. If you plan
to participate, you MUST complete the Volunteer Registration Process. This includes: completion of the
Volunteer Registration Form, submission of the Volunteer Service Statement & Agreement , submission of the
Confidentiality Agreement, and completion of the Criminal Background Check including fingerprinting at the
The Northwood School depends on the generous support of its volunteers. School volunteers participate in a
variety of ways. Whether you plan to work in the school every week or help out on special occasions, your time
and effort will be greatly appreciated. Please complete these forms and return them to the office or to your
If you have any questions, please contact one of the Volunteer Coordinators: Kathy Thoms (942-8137;
firstname.lastname@example.org) or Kelly Adams (463-8864; email@example.com).
I would like to:
(Please check all areas that you would be interested in helping with; this is not a firm commitment but will let
us know what you are most interested in doing.)
____ chaperone field trips ___ I would like work at PTA functions.
____ chaperone the ski program ___ I would like more info about the PTA.
____ chaperone dances
____ Wellness Committee Member ___8th Grade Trip & Graduation Committee
These are one-time events that will generally require 1-3 hours of volunteer time.
___ Field Day ___ X-Country Meets ___ Bike Rodeo
___ Jump Rope for Heart ___ School Picture Day ___ Vision & Hearing Screenings
___ Annual Book Fair ___ Artist-in-Residence ___ Art Show setup/breakdown
___ Read Across America ___ NECAP Testing helper ___ Provide Healthy Snacks for
___ Intramural Soccer (4 sessions) ___ Intramural Basketball (4 sessions)
___ Wellness Committee Family Fitness Programs
WEEKLY IN-SCHOOL VOLUNTEERING:
In school volunteers time slots are regular weekly commitments that are determined by the volunteer and the
teacher/staff member. Time slots can be as brief as one hour each week or as extensive as several hours several
times a week. Generally, teachers are most in need of help with clerical work and are happy to have volunteers
for 1-2 hours per person per week (photocopying, collating, etc.)
___ in-school materials prep & clerical support ___ Art Room ___ Phys-Ed
___ help in the classroom ___ Music ___ Guidance
___ at-home materials prep & typing ___ Library
Please fill in the days and times you are usually available:
Monday _________________ Tuesday _____________________ Wednesday ____________________
Thursday ________________ Friday_______________________
___ Check here if you have volunteered previously and have completed the Criminal Record Check.
___ Check here if you are a parent with small children at home and would like to partner up with another parent
to share baby-sitting. Exchanging childcare gives each parent a few hours of free time to work in the school.
___ Check here if you plan to volunteer in the school and would like a tour of the facility along with training on
the school equipment (copy machines, laminator, book binder, rizzo machine, etc).
If you would like to volunteer in a capacity not listed above, please describe: _____________________