New Volunteer Information
Thank you for wanting to join our team! Please fill out the application in full. After you have filled out the application, and paid the online application fee, please sign up for one of our Sidewalker trainings online. You can register in the Event Section of our Website. Healing Reins will not share your information; all information is kept confidential.
Name
First Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date Picker Icon
Age
*
Gender
*
Primary Phone (please tell us if it is cell or home )
*
Email Address
*
Street Address
*
City
*
Zip Code
*
School or Employer
Are you (check all that apply):
*
Minor
Adult with Legal Guardian or Caregiver
Independent Adult
Veteran
How did you hear about us?
*
Word of Mouth
Received a volunteer information card in the mail or as a handout
Social Media/TV
For minors or adults with legal guardians/caregivers:
Parent or Guardian Name
Phone Number
-
Area Code
Phone Number
Email Address
Health History
Please list all medication (including medical marijuana)
*
Please note any allergies and if EpiPen or inhaler is used
*
What is your general health status? Tell us about any special needs or health concerns:
*
Do you have health insurance?
Yes
No
Health insurance company name & policy #:
Date:
*
-
Month
-
Day
Year
Date Picker Icon
Volunteer Consent & Release Form
CONSENT FOR EMERGENCY MEDICAL TREATMENT: In the event of an emergency, if medical aid/treatment is required due to illness or injury while volunteering with, or while being on the property of, Healing Reins Therapeutic Riding Center (“HRTRC”), an Oregon non-profit corporation, I authorize HRTRC to secure and retain medical treatment and/or transportation if needed. This authorization includes any treatment deemed necessary by a treating health care professional and includes, but is not limited to, x-ray, surgery, hospitalization, and medication. In addition, I authorize HRTRC to release my/my child/my ward’s records to any individual involved in medical treatment and/or necessary transportation.LIABILITY RELEASE: Under Oregon Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of participating in equine activities, pursuant to section 30.691, Oregon Revised Statutes. I would like to volunteer in HRTRC’s program. I acknowledge the risks and potential for risks in riding and working with horses. However, I feel that the possible benefits to myself/my child/my ward are greater than the risks assumed. Intending to be legally bound, for myself and my heirs, assigns and legal representatives, I hereby forever waive and release any and all claims, whenever arising, against Faith Run Farms, LLC (“FRF”) an Oregon limited liability company, HRTRC, and their respective directors, officers, members, employees, agents and representatives arising from, or relating in any way to my/my child’s/my ward’s volunteering in any HRTRC program or presence on the FRF property generally.
I accept and agree to the terms and conditions listed above.
*
Agree
Photo & Publicity Release
I DO/ I DO NOT Consent to and authorize the use and reproduction by Healing Reins Therapeutic Riding Center of any and all photographs and any other audio/visual materials taken of me for promotional material, educational activities, exhibitions or for any other use for the benefit of the program.
*
I DO
I DO NOT
Volunteer Signature OR Parent/Guardian Electronic Signature if volunteer is a minor
Clear
Date Signed
*
-
Month
-
Day
Year
Date Picker Icon
Emergency Contact Information
Emergency Contact Name
*
Relationship to Participant
*
Phone Number
*
Volunteer Jobs
Volunteers are the heart and soul of our programs and critical to the success of our mission. Healing Reins is able to provide its nationally accredited, therapeutic programs because of the donations of time and talent of specially trained community volunteers. There are a wide variety of volunteer jobs available at Healing Reins, the most important being the "sidewalker" and "leader" positions that support our participants in their lessons. SIDEWALKER: Works with our participants in the arena.A Sidewalker’s job is to empower the participant in all phases of the lesson. Sidewalkers interact with and guide the client, and also serve as an extra set of eyes and ears for the instructor. Sidewalkers are responsible for the participant’s safety, comfort, learning, and interaction with the horse. LEADER: Works with the horse during the lesson. A Leader’s job is to retrieve the horse from the paddock, bring the horse into the barn before the lesson, help with grooming and tacking, and handle the horse during all phases of the lesson. Leaders are primarily responsible for addressing the comfort and safety of the horse, and will interact with and observe the horse at all times to ensure the safety of the participant.*No experience is necessary to begin helping as a lesson volunteer at Healing Reins. We provide all the training necessary for you to be successful at the barn. All trained volunteers are automatically eligible to work as sidewalkers helping participants in the arena. **Volunteers who wish to become leaders must show competency in handling equines and must participate in a specialized leader training conducted at Healing Reins.
What type of Volunteering Interests you?
*
Helping participants in the arena
Office work
Facility/ Barn Work
Special event help
Do you have any previous horse experience?
*
Yes
No
I don’t have previous experience but I would like to learn more about horses.
If you answered yes, please explain.
Do you have any special talents or skills in the following areas?
Marketing, advertising, promotions and social media
Special event planning, auction planning, procurement
Fencing, electrical and building repairs or maintenance
Data entry
Healing Reins requests each volunteer to pay a $25 processing fee prior to orientation.
I agree to pay the $25 fee either online or bring to the training
*
Yes
Confidentiality Agreement
Healing Reins Therapeutic Riding Center shall preserve the right of confidentiality for all individuals in its program. 1.The staff shall keep confidential all medical, social, referral, personal and financial information regarding a person and his/her family. 2.The staff will not disclose information to outside agencies or individuals without specific written consent of the rider or parent/guardian. 3.The volunteer will keep confidential all information about rider, family, parent/guardian. In the case of a breach of this confidentiality the volunteer will be reprimanded. If this occurs again, the volunteer will be terminated.
I accept and agree to the terms and conditions listed above.
*
Agree
Signature
*
Clear
Date
*
-
Month
-
Day
Year
Date
Healing Reins Background Check
Pre-Employment or Volunteer Authorization Form***Not required for volunteers under the age of 18The undersigned consents to have P.I.V. obtain any and all information concerning previous employment, obligations and all other matters which may be required in connection with their pre-employment or volunteer screening process. The undersigned consents to any other background check, including, but not limited to: criminal checks, credit reviews and driving records (MVR).P.I.V. does not guarantee the accuracy of information received from various sources, which may contain errors and omissions. P.I.V. provides NO WARRANTY AS TO THE MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE FOR ANY INFORMATION. Original records may differ from computer entries. P.I.V. shall not be liable for any direct, indirect, incidental, or consequential damages caused by mistakes, omissions, deletions, error, or defects in any information provided by other sources.P.I.V. shall provide a copy of the information received to the prospective employer. If the undersigned believes that any of the information provided is incorrect, the undersigned must notify P.I.V. within fourteen (14) days in order to allow P.I.V. to re-verify the information and provide a copy of the notice to the prospective employer. Questions regarding the pre-employment or volunteer checks should be directed to P.I.V. at (541) 548-5306 or via mail at Post Office Box 1913, Redmond, OR 97756.
List other Names Previously used (including maiden name)
Oregon Driver License/Identity Card Number and State Issued
1. Have you ever been convicted of a sex-related crime?
Yes
No
2. Have you ever been convicted of animal cruelty or neglect?
Yes
No
3. Have you been convicted of a crime involving violence or threat of violence in the last 10 years?
Yes
No
4. Have you been convicted of a crime involving drugs or alcohol in the last 10 years?
Yes
No
5. Have you been convicted of a crime except a minor traffic violation in the last 10 years?
Yes
No
6. Have you been arrested for a crime for which there has not yet been an acquittal or dismissal?
Yes
No
7. Please list the all states in which you have resided during the last 10 years.
I hereby grant the company, P.I.V., permission to check civil and/or criminal records to verify any statements made on this form.
I Agree
Regardless of whether the applicant grants consent, P.I.V. will conduct a criminal offender record check of the applicant. Discrimination by an employer on the basis of arrest records alone may violate federal civil rights laws. The applicant may obtain further information concerning the applicant’s rights by contacting the Bureau of Labor and Industries, Civil Rights Division, State Office Building, Suite 1070, Portland, OR 97232, telephone (503) 731-4075.
I acknowledge receipt of this notice
I hereby grant the company, PIV, permission to check civil and/or criminal records to verify any statements made on this form.
Agree
Volunteer Signature:
Clear
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: