As a volunteer, I understand that the San Juan College Volunteer Center acts as a referral source only. I agree to release, indemnify and hold harmless the Volunteer Center, San Juan College and its employees, agents, and representatives from all liability or claims of liability, including attorney fees and costs of defense, of any nature whatsoever resulting from my service as a volunteer. This release covers all claims I might have and indemnifies San Juan College, its employees and agents for all claims of third parties relating to my acts or failure to act.

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First Name:
Last Name:

Address:
City:

State:

Zip:

Phone:

Email:

How did you hear about the Volunteer Center:

Days and times available:

What area interests you?

Arts/Culture	Senior Services	Justice System
Drug/Alcohol Treatment	Social Services	Develop. & Physic. Disabled
Child Care	Youth Services	Education
Health	Animal Care	Family Services
Community Development	Environment	Other

Comments:

Would you like us to enter you into a volunteer pool for special events or activities? Yes No