Volunteer Application

VOLUNTEER APPLICATION
Volunteer Name*
First and Last Legal Name
Birth Date:*

MonthDayYear
Date
Today Date

MonthDayYear
Date
Age
Gender:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone

Area CodePhone Number
Email:*
example@example.com
Please list any relevant certifications (PSIA, PATH, CPR, etc.)
Parent/Guardian Information

(For Volunteers under 18)
Parent/Guardian Name
Parent Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact:
Relationship
Phone Number

Area CodePhone Number
Food/Drug Allergies
Days and Times Available:*

Year RoundSpringSummerFall/Winter

Times Available

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
AM
PM

Availability Notes (optional)
Attestations*

I understand that Solid Ground Equine Assisted Activities and Therapy Center staff members have the authority to exclude Volunteers from the program for behavior they deem to be unsafe.I give permission for the release and exchange of confidential information to professionals and staff.I give my consent to Solid Ground Equine Assisted Activities and Therapy Center and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for any injury that could arise from participation in equine assisted activities and therapies.I agree to submit to any requested screening to maintain active status that include, but not limited to, criminal background check, drug screening, and other reference checks.
Signature*

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Assumption of Risk and Release of Liability
ASSUMPTION OF RISK

The Participant agrees and/or their representative is aware that riding, handling, or working with animals can be very dangerous, with a high risk of serious injury or death, to both the participant and the animals(s). There are inherent risks of property damage, injury, or death in this activity that no amount of care, caution, instruction, or experience can eliminate. The participant is also aware that any interaction or handling of farm animals is an unpredictable activity. Such dangers can include but are not limited to being stepped on, bitten, kicked, dragged, run into, head-butted, jumped on, etc.

ASSUMPTION OF RISK - Nature Conditions

In addition to the above risks, The Participant agrees and/or their representative understands there are natural risks that Solid Ground EAATC cannot control. These risks include, but are not limited to, loose dogs, horses, animals, and other unpredictable event activities that may cause unpredictable behavior from animals. Nature conditions including, but are not limited to, earthquakes, fire, lightning, thunder, extremely heavy winds, rain, snow, sleet, hail, mud, etc. The Participant and/or their representative agrees freely to assumes all risks, including any negligence by Solid Ground EAATC.

The Participant agrees and/or their representative recognizes that the risk of serious injury is increased by not following the stated guidelines - and recognizes that there is a significant element of risk involved in the handling of animals and horseback riding. The Participant agreed to follow rules and instructions by Solid Ground EAATC personnel and will comply with all program rules & terms.

The Participant agrees and/or their representative to indemnify and hold harmless Solid Ground EAATC from all losses, claims, actions, causes of actions, or proceedings of any kind which may be initiated by participants or by any other person or organization on Event Attendee’s behalf, including demands for damages, judgments, costs, loss of services, or expenses arising from activities contemplated by this agreement, including but not limited to reasonable attorney fees incurred by Solid Ground EAATC.

RELEASE OF LIABILITY

The program at Solid Ground EAATC located at 630 Griffith Lane, Klamath Falls, Oregon 97603; provides small animal, farm, equine-assisted activities, and horse-riding activities. No student will be accepted for riding instruction and no volunteer accepted for service until this form has been read, understood, completed, and signed by the parent(s), caregivers(s), and/or guardian(s) of a minor, or if the student or volunteer is of legal age and sound mind, by the student or volunteer.

Participation in the program is under strict supervision and every effort is made to avoid injury or accident, the undersigned acknowledges the inherent risks involved in riding and working around horses and animals. I have read and consented to the Assumption of Risk and Release of Liability. In consideration for being permitted to participate in horse-related and animal-related activities by Solid Ground EAATC, The Participant and related parties do forever discharge and release from legal liability and not to sue Solid Ground EAATC for any injuries or property damage caused by or resulting from any access to Solid Ground's horses or farm animals, including incidents arising out of Solid Ground EAATC’s negligence.

ORS 30.691 LIMITATIONS ON LIABILITY; EXCEPTIONS.
(1) Except as provided in subsection (2) of this section and ORS 30.693, an equine activity sponsor or an equine professional shall not be liable for an injury to or the death of a participant arising out of riding, training, driving, grooming or riding as a passenger upon an equine and, except as provided in subsection (2) of this section and ORS 30.693, no participant or participant’s representative may maintain an action against or recover from an equine activity sponsor or an equine professional for an injury to or the death of a participant arising out of riding, training, driving, grooming or riding as a passenger upon an equine.
(2)(a) The provisions of ORS 30.687 to 30.697 do not apply to any injury or death arising out of a race as defined in ORS 462.010.
(b) Nothing in subsection (1) of this section shall limit the liability of an equine activity sponsor or an equine professional:
(A) If the equine activity sponsor or the equine professional commits an act or omission that constitutes willful or wanton disregard for the safety of the participant and that act or omission caused the injury;
(B) If the equine activity sponsor or the equine professional intentionally injures the participant;
(C) Under the products liability provisions of ORS 30.900 to 30.920; or
(D) Under ORS 30.820 (Action against the seller of a drugged horse) or 608.015

APPLICABILITY TO LANDOWNER AND LESSORS

The Participant and their legal representative, and on behalf of my spouse, heirs, assigns, personal representatives, and next of kin, hereby release and hold harmless, Solid Ground Equine Assisted Activities and Therapy Center, the host organization and facility, any owners, sponsors, volunteers, employees, agents, officers or directors of the above organizations, and if applicable, landowners and lessors of premises used to conduct the event (collectively the “Releasees”) concerning all injuries, disabilities, loss of life or damage to person or property occurring or arising out of participation in the program. I agree to release any liability by the Solid Ground EAATC or any of the organizations or persons connected with the above-named facility.

I have read this Assumption of Risk and Release of Liability Agreement, fully understand its terms, understand that I have given up substantial rights by signing it and sign it freely and voluntarily without any inducement. If the participant is under the age of 18, this certifies that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the releasees, and, for myself, my spouse, my heirs, assigns, and next of kin, I forever release and agree to indemnify, defend and hold harmless the releasees from all liabilities as set forth above arising out of or occurring from my minor child’s involvement or participation in Solid Ground EAATC activities organized or sponsored or run by any of the releasees, their agents or representatives.
Name:
Volunteer/Guardian Signature*

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PHOTOGRAPH & VIDEO RELEASE FORM
I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. Photos, audio, or video may be used for the following purposes: social media, publications, and educational or conference presentations.

I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

I also understand that this material has no time restrictions and may be used in diverse educational settings within an unrestricted geographic area. I understand that no personal information will be used in any publications unless express consent is given.

I also understand that my consent can be withdrawn at any time in writing to Solid Ground Equine Assisted Activities and Therapy Center at 630 Griffith Lane, Klamath Falls, OR 97601.

By signing this form, I acknowledge that I have completely read and fully understand the above information and release all audio, and video recording claims against Solid Ground Equine Assisted Activities and Therapy Center
Volunteer/Guardian Signature*

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Name:

STATEMENT OF CONFIDENTIALITY
It is the policy of Solid Ground Equine Assisted Activities and Therapy Center (Solid Ground EAATC) that all employees, volunteers, and Board members of Solid Ground EAATC will not disclose confidential information belonging to, or obtained through their affiliation with, Solid Ground EAATC to any person or entity. This policy is not intended to prevent disclosure that is required by law.

I agree that I will not at any time - during my tenure at Solid Ground EAATC and in the years following that tenure - divulge any such confidential information, nor transfer any such confidential information to any third party. I agree I will not use any such confidential information for my own purpose or for any purpose other than in connection with my authorized role at Solid Ground EAATC, unless such disclosure shall have been approved in advance by the Executive Director.

I agree that upon completion of my participation at Solid Ground EAATC that I will return to Solid Ground all confidential information on the organization in my possession or under my control. I understand that failure to uphold the above statement could result in dismissal from Solid Ground Equine Assisted Activities and Therapy Center programs and/or legal action if necessary.

I have read Solid Ground EAATC’s complete Statement of Confidentiality presented above. I agree to abide by the requirements of the policy and this statement.
Volunteer Signature*

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Parent/Guardian Signature (if applicable)

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Name:

BARN RULES
General
- Speed limit is 5 mph.
- The barn closes at 8:30.
- This facility prohibits smoking, alcohol, and the use of recreational drugs.
- Weapons are not permitted on property.
- Dogs by special permission only- all non-property animals must be cleared with the Program Director and the facility.
- Please respect all animals on property, including all dogs, cats, and horses.
- All visitors handling horses must sign a liability release.
- Horses being turned out will be supervised by an instructor, or advanced volunteer. Including round pens, arenas, and pastures. Arena turn-outs by special permission only.
- Please do not leave children unattended – no running in alleyways, or around arenas.
- Respect the off-limits areas, and equipment.
- No climbing on 4-wheelers, haystacks, tractors or any other machines.
- Walk through doors are for humans only; wheelbarrows and horses must go through the roll-up doors
- Please knock before opening a door.
- Gates must be closed on all turnouts, round pens and arenas at all times.
- Horses should only be tied to hitch rails, rings in stalls or cross ties in main barn. Do not tie with bridle reins. They should not be tied to hydrants, fences, posts, stall fronts, or stall side panels. Damage will be billed to client at published rates.
- Park in an orderly fashion only in designated areas. Trailers are to be parked south of the turnouts.
- Keep areas in front of barn clear of vehicles.
- Please wear proper attire while participating in program activities.
  - Hard sole-shoes, boots, or sturdy footwear (no steel-toed boots)
  - Jeans or long pants
  - Sleeved shirts (t-shirt, button up, long-sleeve, etc)
  - Avoid jewelry that could become tangled in tack
  - Avoid strong perfumes, or body sprays
- Be sure to sign-in or check-in when arriving for lessons or volunteer time.
I acknowledge I have reviewed the Solid Ground Equine Assisted Activities and Therapy Center rules. I fully understand that I am responsible for my actions while I am at this facility. I acknowledge I shall be liable to Solid Ground Equine Assisted Activities and Therapy Center for any property damage caused by gross negligence. Failure to follow the above rules will result in my dismissal from the program.

By signing below, I promise to respect the rules of Solid Ground Equine Assisted Activities and Therapy Center
Volunteer/Guardian Signature*

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Name:

VOLUNTEER RESPONSIBILITIES & AGREEMENT FORM
Volunteers Agree to:
- Complete all paperwork accurately
- Submit to all requested or randomized criminal background and drug screenings
- Adhere to PATH standards and safety rules
- Support the Solid Ground Equine Assisted Activities and Therapy Center Equine Therapy Program’s vision and mission
- Maintain strict confidentiality, particularly regarding any and all medical, social, referral, personal, and financial information, written and/or verbal about participants and other volunteers. Understand that we are here to serve the Veteran and special needs populations, we are not set up to offer riding lessons to the general public
- Commit to and keep all appointments, contacting the Instructor with any schedule conflict at least 24 hours prior. Respect lesson times and only visit during scheduled sessions or times agreed upon with a staff member
- Arrive on time (20 minutes prior to scheduled lesson) and stay until lesson and clean up are complete. Stay within the therapeutic working area including:
  - The Tack Shed
  - Riding Arena
  - Main Barn
  - Volunteer Office
- Volunteer will conduct themselves in a professional manner at all times and refrain from using offensive or inappropriate language and conduct
- Abide by Solid Ground Equine Assisted Activities and Therapy Center
- Perform all assigned tasks to the best of your ability and not under the influence of alcohol and/or drugs
- Be courteous and respectful to the public, volunteers, employees, and treat with courtesy each individual with whom you come in contact regardless of race, color, religion, age, gender, sexual orientation or national ancestry
- Be supportive of the instructors and their activities at all levels
Volunteer Responsibilities and Duties:
- Complete volunteer training and sign all needed forms
- May possibly be asked to assist riders weighing up to 200 pounds
- Be willing to be outdoors in many types of weather
- Be able to follow direction from instructor in a fast paced setting
- May walk 45+ minutes in a sand arena and jog for short distances
- Program volunteers work under the direct supervision of a PATH certified Instructor
- Prepare, groom and tack horses for scheduled lesson
- Dress safely and appropriately
- Promote rider independence and success
- Alert the instructor of any safety concerns
- Assist instructor in maintaining a safe environment
- Assist in emergency situations
- Become familiar with the safety precautions to be observed in the program
- Keep barn and therapeutic shed clean and organized
Side Walker Responsibilities:
- Assist instructor during mounting and dismounting as requested
- Communicate with participants when appropriate, including verbal/non-verbal prompts
- Provide physical assistance and stabilization to the rider when directed or necessary
- Remain focused on assisting the participants
Horse Leader
- Responsible for leading horse, walking alongside horse without a lead, or may be stationed in the arena for spotting
- Focus remains on working with the horse and the horse’s needs
- Communicate with instructor regarding any horse related questions or concerns
Instructor in Training
- Apprentice to the Instructor
- May be student teaching under the guidance of an instructor
- Follows all of the instructors instructions
*Extra volunteers may be asked to do things such as help with activities, games, or cleaning of the shed*

By signing this form I acknowledge that I have completely read and fully understand the requirements listed above and agree to these terms.
Volunteer/Guardian Signature*

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Name:
Status
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VOLUNTEER APPLICATION

Parent/Guardian Information

Emergency Information

Assumption of Risk and Release of Liability

PHOTOGRAPH & VIDEO RELEASE FORM

STATEMENT OF CONFIDENTIALITY

BARN RULES

VOLUNTEER RESPONSIBILITIES & AGREEMENT FORM