BAXTER STATE PARK

FAMILY/GROUP VOLUNTEER SERVICE APPLICATION

DATES AVAILABLE:_____________________ Group/Org Name:_______________________

Contact Person:_____________________________ Address:_____________________________

Phone #:___________________________ Email:______________________________________

FAMILY/GROUP MEMBERS: EMERGENCY CONTACT:
NAME
DOB
NAME
PHONE #
1.__________________________ ______ _________________________ ____________
2.__________________________ ______ _________________________ ____________
3.__________________________ ______ _________________________ ____________
4.__________________________ ______ _________________________ ____________
5.__________________________ ______ _________________________ ____________

EDUCATION: Indicate highest level completed

Elementary
High School
College
Major
1._______________ __________________ __________________ __________________
2._______________ __________________ __________________ __________________
3._______________ __________________ __________________ __________________
4._______________ __________________ __________________ __________________
5._______________ __________________ __________________ __________________
OCCUPATION INTERESTS HOBBIES SPECIAL SKILLS
1._________________ __________________ __________________ __________________
2._________________ __________________ __________________ __________________
3._________________ __________________ __________________ __________________
4._________________ __________________ __________________ __________________
5._________________ __________________ __________________ __________________

AGREEMENT FOR VOLUNTEER SERVICE

I UNDERSTAND THAT IF ACCEPTED AS A VOLUNTEER:

  1. I shall be subject to all Baxter State Park Rules & Regulations.
  2. I shall not have the status of an employee of the State of Maine.
  3. I shall not receive compensation for my services.
  4. I will provide all necessary camping equipment and supplies: unless advised of other arrangements by Park staff.
  5. I will be available for a minimum of one week if volunteering as a campground assistant or maintenance assistant and will contribute a minimum of twenty-eight (28) hours of work per week.
  6. I will operate Baxter Park Vehicles and/or equipment only if I hold proper license, have specific permission from and am under supervision of Baxter Park staff.
  7. I shall maintain an appearance and conduct myself in a manner complimentary to Baxter State Park.
  8. I shall not use my status as a volunteer to secure access to areas of the park not accessible to others, for the purpose of obtaining material by camera, video camera, or other means to be used for commercial purposes.

Insurance: All volunteers must be 18 years of age or older to be covered under Baxter State Park volunteer program accident policy. If you have your own health insurance, you can stretch Baxter Park's limited budget by not enrolling in their accident policy program.

Do these family/group members, 18 years or older, wish to be enrolled in BSP's accident plan?

Signature of Applicant(s) Date

Insurance(Yes or No)

If no, company name & policy #

1._______________________ ______________ ___________ _______________________
2._______________________ ______________ ___________ _______________________
3._______________________ ______________ ___________ _______________________
4._______________________ ______________ ___________ _______________________
5._______________________ ______________ ___________ _______________________

APPLICATION ACCEPTED: _____________________(Chief Ranger)DATE:____________

APPLICATION REJECTED:  _________________________________DATE: ___________