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Ambassador Application Form

  1. Please print all information -- Thank You.

  2. In the space provided above, please add any additional information relative to your application such as your availibility.

  3. I covenant and agree to indemnify and hold harmless the City of Lima, its officials, officers, employees, agents, successors, assigns, and insurers, from all liability, loss, and expense, including but not limited to damages, attorney fees and cost of defense, in any matter arising from my participation in this volunteer program.

  4. By checking "I Agree" you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.

  5. Leave This Blank:

  6. This field is not part of the form submission.