Volunteer Service Agreement & Release Volunteer Code of Ethics One Day Events

PERSONAL CONTACT INFORMATION

Name________________________________________________________________________________________ Address___________________________________ City !hone Email Address ortunities 'ith the City of San (ose) Zi

!lease chec"# $es% & 'ould li"e to receive emails concerning volunteer o Emergency Contact*Relationshi *!hone

+edical ,ac"ground - !lease note any hysical or medical conditions that should .e considered in your assignment)

&% ____________________________________% agree to volunteer my services to the C&/$ O0 SAN (OSE 12City23 and to com ly 'ith the City4s volunteer Code of Ethics) & ac"no'ledge that there is no salary or other com ensation% or ri5es of any "ind to .e rovided .y the City for my services as a volunteer) Re'ards or ri5es for volunteer service to the City may .e offered .y other ersons6 ho'ever% the City is not res onsi.le for the ayment of any such re'ard or ri5e to me)

I understand that during the course and scope of my or my chi!d"s# $o!unteer ser$ices to the City% I or my chi!d# &i!! 'e co$ered under the City(s )or*ers( Compensation se!f+ insurance, I a!so understand and agree that my so!e remedy for any in-ury that I or my chi!d# may sustain during the course and scope of my or my chi!d"s# $o!unteer ser$ices to the City% &hich is co$ered 'y )or*ers( Compensation% sha!! 'e through the City(s )or*ers( Compensation se!f+insurance co$erage, I &ai$e any other right or remedy that I or my chi!d# may ha$e against the City of San .ose% its emp!oyees% officer% and agents co!!ecti$e!y referred to as /City0# a$ai!a'!e to me for an in-ury as descri'ed a'o$e inc!uding an in-ury arising out of the City"s neg!igence#, Further% I re!ease the City from a!! other !ia'i!ity arising from my or my chi!d"s# $o!unteer ser$ice or acti$ities as pro$ided hereunder, & understand that the City of San (ose may hotogra h or videota e the volunteer events or activity in 'hich & am 1or my child is3 artici ating) & give my ermission for the City to use hotogra hs or videota e of me 1or my child3 for the ur ose of romoting the City of San (ose and its services* rograms) & give my ermission 'ith the follo'ing understanding# No compensation of any *ind &i!! 'e paid to me or my chi!d# at this time or in the future for the use of my or my chi!d(s# !i*eness,

& also ac"no'ledge and agree that my 1or my child4s3 services are rovided for the convenience of the City and may .e terminated for any reason or for no reason and at any time .y the City 'ithout rior notice or hearing) &% the undersigned% certify that the information stated on this agreement and release is true% com lete and correct to the .est of my "no'ledge and .elief and is made in good faith) Any false statements made .y me may .e used as a .asis of re7ection for this a lication or termination of volunteer services)
/his agreement shall remain in effect until terminated in 'riting .y either arty) Additional information may .e rovided on the attachments)

City of San .os1 2o!unteer Code of Ethics Agreement

Volunteers are an im ortant asset of the City4s 'or"force and ma"e it ossi.le for the City to deliver services to San (os8 residents) As a volunteer% you re resent the City of San (os8) As such% it is im ortant that you adhere to the City4s Volunteer Code of Ethics) &% ____________________________% as a volunteer 'ith the City of San (os8 agree to# Conduct myself in a rofessional manner6 maintaining high standards of integrity and honesty) /reat all mem.ers of the u.lic% em loyees% and other volunteers 'ith res ect and courtesy) Avoid any activity that could .e seen as a conflict of interest% such as acce ting gifts or favors from individuals or .usinesses that could .e seen to .e an attem t to influence a City decision) Res ect confidential information that is availa.le to me as a result of my volunteer 'or" 'ith the City% and refrain from using it for ersonal gain or for ersonal% non9City .usiness related reasons) ,ring any violation of this confidentiality to my su ervisor) !rom tly raise :uestions and concerns regarding ossi.le violations of City olicy or local% State or 0ederal la' 'ith my immediate su ervisor or another manager 'ithin my de artment) Reinforce the City of San (os8;s commitment to e:ual em loyment o ortunity and a 'or" environment free of discrimination and harassment% including se<ual harassment) !lease see Section =)=)=)% titled Discrimination and >arassment !olicy% in the City !olicy +anual)

& understand that & may .e released from my volunteer osition 'ith the City of San (os8 for not adhering to the a.ove Code of Ethics) ________________________ Volunteer Signature ________________________ Date ________________________ Organi5ation ________________________ !arent*?uardian if under =@ yrs old ________________________ Date ________________________ !osition