White Diamond Dane Rescue Volunteer Application

Thank you for your interest in becoming a volunteer with White Diamond Double Merle Dane Rescue (WDDMDR) Volunteers are always needed, and very much a part of our succeeding! Please answer the following questions to the best of your ability, so we can get to know you better, and someone will contact you shortly.

Name*

First NameLast Name

E-mail*

Are you over 18 years old?*

Phone Number - Cell*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

List any skills or experience that would lend to your volunteer position or area of interests?

Comments

Do you have any physical limitations that limit your ability to volunteer in certain areas?*

If so, Please explain

If interested in transport, Do you have a reliable vehicle with heat, and air conditioning?

Do you have a valid Drivers License?

Do you have liability Insurance for your vehicle?

Insurance Company Name?

Have you or are you volunteering for another rescue organization?

Which organization? When? and what kind of volunteer work did(do) you help with?

How many hours per month would you be comfortable with volunteering for WDDMDR?

Liability Waiver for Volunteer/Participant:

As a volunteer/participant of White Diamond Double Merle Dane Rescue, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages, or loss which I may sustain as a result of volunteering/participating in any and all activities associated with White Diamond Double Merle Dane Rescue.

I do hereby fully release and discharge White Diamond Double Merle Dane Rescue, their officers, agents, servants, employees, and other volunteers from any and all claims from injuries, including death, damages, or loss which may accrue to me on account of my volunteering/participating with White Diamond Double Merle Dane Rescue.

I further agree to indemnify and hold harmless and defend White Diamond Double Merle Dane Rescue, their officers, agents, servants, employees, and other volunteers from any and all claims resulting from injuries, including death, damages, and loss sustained by me and arising out of, connected with, or in any way associated with volunteering/participating with White Diamond Double Merle Dane Rescue.

Photo Release:

During my volunteer time with White Diamond Double Merle Dane Rescue, I understand my photo may be taken at various events and outings. By signing below, I also hereby grant White Diamond Double Merle Dane Rescue permission to use my likeness in photographs, and/or videos in any and all of it's publications, or online. I will make no monetary or other claim(s) against White Diamond Double Merle Dane Rescue for the use of my photo, or video.

** I have read, and understand the foregoing, and I am 18 years of age or older.

I Agree

Please type your name to add signature*

Date*

Date