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Fix-it Clinic Volunteer Form
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Bring your skills as a fixer to Washington County Library’s upcoming Fix-It Clinics! You can help people save items such as small household appliances, electronics, or clothing and more from being thrown away. After submitting this form, a Washington County Library staff member will contact you to learn more about your area of fixing interest, and coordinate your time at the Fix-It Clinic.
Emergency Contact Name
Please list your skills that pertain to the Fix-it Clinic program.
How did you hear about volunteering at our Fix-it Clinic?
I am requesting to be allowed to participate as a volunteer for Washington County Fix-It Clinics. Volunteers participate in the Washington County Library programs (hereinafter the “Program”) at their own risk. I understand that Program activities may involve certain inherent risks, including the risk of physical injury. I understand that I am not an employee of Washington County, thus I am not eligible for workers’ compensation benefits if an injury/illness occurs. I currently have no known physical condition that would impair my ability to participate in the Program, including, but not limited to, engaging in vigorous physical activities. I have carefully considered the risks involved and voluntarily agree to participate in the Program. I understand it is in my best interest to thoroughly list all training and experience. All statements made on this form are true, complete and correct to the best of my knowledge and belief. I understand these statements are subject to verification. My misrepresentation or falsification of information or material omissions may result in subsequent dismissal from volunteer service if discovered at a later date. Falsification or omission may also result in my not being considered for future volunteer service opportunities. My submission of this form is my consent for Washington County and its agents to conduct all necessary checks needed to meet the requirements for this position and my agreement to supply all required information. Final offers of volunteer service will be conditional pending results of reference checks and criminal conviction/background check as applicable to the position. My failure to provide information will disqualify me as a volunteer. I have carefully read and fully understand the above information.
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