2011 U.S.

Figure Skating Official Volunteers Sponsor

Championships For Office Use Only:

____ Application (pages 1-2) Received

VOLUNTEER APPLICATION ____ Security Check Release Received

January 22-30, 2011

____ Security Check Complete
____ Confirmation Sent
Please print clearly. Only one applicant per form.
Committee Assignment: ________________
This form can be copied.

Name: ____________________________________________________ Date of Birth ____/____/_______ Male / Female (circle one)

First Middle Last

Address: ________________________________________________ City ________________________ State ______ Zip ___________

Daytime Phone: ____________________ Evening/Cell Phone: _______________________ Fax #: _______________________________

Email: ________________________________________Occupation: _______________________ Employer: _______________________

 Volunteers must commit to a minimum of 24 hours (four 6-hour shifts)

 There will be a mandatory training session in December 2010
 Volunteers must be able to work between Thursday, January 20 and Monday, January 31
 Dates, times, and areas to work are requests only. There is no guarantee they will be met.

____ Please check here if you have purchased All-Event Tickets. All-Event ticket purchasers will be given priority for choice of hours
to assure that you can watch the events you choose.

Please select your tee shirt size. ____S ____M ____L ____XL ____XXL

Day Thurs. 1/20 Fri. 1/21 Sat. 1/22 Sun. 1/23 Mon. 1/24 Tues. 1/25 Wed. 1/26 Thurs. 1/27 Fri. 1/28 Sat. 1/29 Sun. 1/30 Mon. 1/31

6am-12pm

12pm-6pm

6pm-12am

Indicate with an X when you are available. At least 4 shifts must be selected. There are limited opportunities available on 1/20, 1/21, and 1/31,
so please do not select only those dates for your volunteering.

VOLUNTEER ASSIGNMENTS: Mark the area in which you are most interested by putting 1, 2, or 3 next to the area, with 1 being first preference.

__ Registration (need computer experience) __ Hospitality/Special Events __ Credential Monitor

__ Greeter/Information/Transportation (local resident) __ Communications/Copy Center __ FanFest
__ Competition Services __ Office Services/Volunteer Support __ Media Services
__ Operations/Event Set-Up & Tear Down __ Wherever Needed

List previous figure skating and/or event volunteer experience:

List your skills and/or expertise (such as computers, hospitality) in a particular field:

___ (Check if applicable) I am a North Carolina resident interested in volunteering for opportunities to promote the 2011 U.S. Figure Skating
Championships in advance at festivals, Coliseum events, trade shows, etc.

Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 27513
return by 10/31/2010 by fax: 919-678-1655

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2011 U.S. Figure Skating Championships
VOLUNTEER APPLICATION
January 22-30, 2011
Please print clearly. Only one applicant per form. This form can be copied.
Volunteers must be 18 years of age by December 1, 2010

Your Name: __________________________________________________

IN CASE OF EMERGENCY, PLEASE NOTIFY:

Name: __________________________________________________ Relationship to You: __________________________________

Daytime Phone: ____________________________ Evening Phone: ___________________________

Selection & Discharge of Volunteers: It is possible that we will receive more volunteer applications than positions available. Therefore, submitting a
volunteer application does not mean that you will be selected as a volunteer. The selection of volunteers from among the qualified applicants is at the
sole discretion of NC 2011 and U.S. Figure Skating and is not subject to appeal and dispute. No reason need be given for the refusal of an applicant.
Volunteers will not be selected or rejected on the basis of race, color, national origin, sex, sexual orientation, marital status or age. Persons with
disabilities must be able to perform the essential functions of the volunteer position for which they are selected; however, persons with disabilities can
perform the essential functions of most volunteer positions. Acceptance as a volunteer creates no rights to compensation or continued service.
Volunteers serve at the pleasure of the 2011 U.S. Figure Skating Championships and U.S. Figure Skating. NC 2011 and U.S. Figure Skating reserve the
right to terminate the service of any volunteer and to reclaim the volunteer credential issued. Termination is at the sole discretion of NC 2011 and U.S.
Figure Skating and is not subject to appeal or dispute.

THE FOLLOWING RELEASE MUST BE READ AND SIGNED TO COMPLETE THIS APPLICATION:

In consideration of being permitted to participate in the 2011 U.S. Figure Skating Championships, and in voluntary recognition and as-
sumption of any risk and hazard associated with my participation, I _____________________________, for myself, and heirs, personal
representatives, successors and assigns, hereby voluntarily release and hold harmless U.S. Figure Skating, North Carolina 2011,
Sports & Properties, Inc., and the Greensboro Coliseum Complex, and each of their officers, trustees, boards, committees, employees,
agents, participants, and representatives, and all other entities or parties associated with the 2011 U.S. Figure Skating Championships
(collectively, the “Released Entities”) from any and all claims, losses, damages and liabilities arising from death, injury, illness or damage
incurred or suffered by me or any other person arising out of, relating to, or resulting from my participation in the 2011 U.S. Figure Skat-
ing Championships and related incidental activities including pre-event set-up and post-event tear down activities. I also approve the
use of my picture, likeness, or voice for promotional use, regardless of whether the picture, likeness or voice was recorded before, dur-
ing or after the 2011 U.S. Figure Skating Championships in any medium.

I also acknowledge that I have been informed that I may be required to provide a set of impressions of my fingerprints and that a
criminal history records check may be performed to determine my eligibility to serve as a volunteer for the 2011 U.S. Figure Skating
Championships. I acknowledge that I have received, read, and understand the “Consent for Criminal History Records Check” that
accompanies this application. I understand that I may be ineligible to volunteer based on the results of the criminal history records
check. I acknowledge that the scope of this Release includes any conduct by the Release Entities related in any way to the criminal
history records check and its results, including any decision to deny my Volunteer Application.

_____________________________________________________________________________________/__ /________________
SIGNATURE OF APPLICANT DATE

VOLUNTEER APPRECIATION PACKAGE:

 Official Volunteer Commemorative Uniform to be worn during volunteer shift

 Complimentary Volunteer Parking (with shuttle service to Greensboro Coliseum Complex)
 Refreshments while volunteering
 Complimentary access to practice viewing
 Ticket purchase discounts

Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 27513
return by 10/31/2010 by fax: 919-678-1655

PRESENTED LOCALLY BY: Page 2/3

 Consent for Criminal History Records Check

I hereby give my permission to U.S. Figure Skating and North Carolina 2011 to obtain information relating to my criminal history
record through a reporting agency that regularly performs background checks. I understand that I may be required to provide a
set of my fingerprint impressions for the records check to be completed. If I am not required to provide fingerprint impressions, I
understand that the records check will be conducted based on my social security number. The criminal history record, as re-
ceived from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications
and delinquent conduct committed as a juvenile. I understand that this information will be used, in part, to determine my eligibil-
ity for a volunteer position at the 2011 U.S. Figure Skating Championships. I also understand that the criminal history could con-
tain information presumed to be expunged.

I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release and forever discharge and
agree to indemnify and hold U.S. Figure Skating and North Carolina 2011 and the organization performing the background
check and each of their respective officers, directors, employees, and agents harmless from and against any and all causes of
actions, suits, liabilities, costs, debts, and sums of money, claims and demands whatsoever (including claims for negligence,
gross negligence, and/or strict liability of U.S. Figure Skating and North Carolina 2011 and the organization performing the
background check) and any and all related attorneys’ fees, court costs and other expenses resulting from the investigation of
my background in connection with my application to become a volunteer for the 2011 U.S. Figure Skating Championships.

I further authorize U.S. Figure Skating and North Carolina 2011 to check my criminal history records with any or all local,
county, state, and federal agencies and records departments as part of my association as a volunteer for the 2011 U.S. Figure
Skating Championships.

__________________________________________ _____________________________________________
Volunteer Signature Drivers License Number/State

__________________________________________ _____________________________________________
Volunteer Name (Print) Social Security Number

__________________________________________ _____________________________________________
Date Date of Birth Gender

__________________________________________ _____________________________________________
City/State of Birth List all States of residence in the past 5 years

Please fill out pages 1-3 and by mail: NC 2011, Volunteer Application, 401 Harrison Oaks Blvd. Suite 215, Cary, NC 27513
return by 10/31/2010 by fax: 919-678-1655

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