City of Grapevine Parks & Recreation


This volunteer-based program assists Grapevine’s senior residents (age 55 and over) with transportation to and from routine medical and dental appointments. Volunteers submit preference for appointment locations, days and times. We work with your schedule! You must have a personal vehicle with valid auto insurance, a valid Texas driver’s license, a valid Social Security number, be 18 years old and agree to both a criminal and motor vehicle history background verification. The City provides insurance coverage for any excess over valid and collectible liability coverage that is in force through the vehicle owner’s policy.  ***NOTE: court-ordered community service volunteers do not qualify for this job.**

What's your email address?

Your information

Required fields are marked with an asterisk (*).
First Name *
Last Name *
Cell Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, City of Grapevine Parks & Recreation will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Date of birth *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Do you have a personal vehicle? *
Do you have valid auto insurance? *
Do you have a valid Texas driver's license? *
Do you have a Social Security Number? *
If you become a volunteer, do you agree to a criminal and motor vehicle history background check? *






I do hereby release, absolve, indemnify, and hold harmless the City of Grapevine and its employees, activity
officials, activity supervisors, any or all of them in the event of any accident, injury or death sustained by the
below named participant(s) while being transported to or from an activity, or while participating in any activity
from any liability of any kind whatsoever. I agree to abide by all PARD program and facility rules,
regulations, policies and procedures, whether posted, written or verbal. Any offensive conduct,
discrimination, harassment, sexual harassment, or other conduct offensive to a person, regardless of
gender, race, color, religion, or national origin, committed by the participant towards another participant or
staff member shall be prohibited and shall result in immediate removal of said participant from all programs
and facilities.


I also give permission for any photographs taken during the time of these activities to be utilized for
promotional uses by the City of Grapevine, now and in the future.