HAKA Volunteer Application

HAKA Volunteer Application

Our Human Helpers
Name

First NameLast Name
Physical Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address (if different from physical address):

Street Address

Street Address Line 2

CityState

Zip Code
Mobile Number:*

Area CodePhone Number
Phone Number:

Area CodePhone Number
Email:*
example@example.com
Employer:
Job Title:
How did you hear about HAKA?
Allergies or physical restrictions:
Shirt size:*
Do you work with any other rescue organizations?*

YesNo
If so, please give contact information for that organization including name and phone #:
Please list any pets you currently care for (or have cared for in the past).
Formal Animal Experience: (check all that apply)*

Boarding FacilityFarm AnimalsFoster HomePet SittingShelter WorkTraining/ObedienceTrappingVeterinary Hospital
Your Volunteer Preferences: (check all that apply)

Adoption - BirdsAdoption - Domestic PetAdoption - Farm AnimalAnimal Care & FeedingCertified Animal RescueClerical/OfficeCommunity OutreachComputer/WebsiteCraftsCustomer Service/Phone callsDog WalkingEducational ProgramsFoster Care - BirdsFoster Care - Domestic PetFoster Care - Farm AnimalFundraisingGrant WritingGraphic ArtsIT/ComputersLand Owner Only (Land available for use)Microchip Scanning (You have a scanner)PaintingPet SittingPhotography/VideoShelter Photographer Animal PortraitsSocial MediaSpecial Events/FundraisersTransport - Domestic PetTransport - Farm AnimalWoodwork/CarpentryWorking with Children
When are you available to volunteer? (check all that apply)*

WeekdaysWeekendsDaysNightsEmergencies Only
Reference #1 (Name, phone # and relationship to self)*
Reference #2 (Name, phone # and relationship to self)
Did someone refer you? If yes, please provide their name and phone #.
In case of emergency, who should we contact? (name and phone #)*
Agreement:

This Volunteer Agreement (“Agreement”) is entered into as of the date set forth below by HAWAIʻI ANIMAL KULEANA ALLIANCE (HAKA). WHEREAS, the Volunteer has voluntarily contacted HAKA and has expressed an interest in working with Animals in the care and/or custody of HAKA. In consideration of HAKA’s agreement to allow the Volunteer to view and/or interact with such Animals, the Volunteer hereby, for his/her heirs, his/her personal representatives, and him/herself represent and warrant as follows: 1. The Volunteer is fully aware of the risks that Animals pose and have elected to view and/or interact with one or more Animals in the care of HAKA voluntarily. The Volunteer knowingly assumes all risks that exposure to Animals may pose, including but not limited to serious bodily injury and/or death. 2. THE VOLUNTEER HEREBY WAIVES, RELEASES DISCHARGES, HOLD HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINST HAKA, its directors, officers, Volunteers, staff, and all other agents, and attorney for any of the referenced parties and any other parties acting for or on behalf of the referenced partied from any and all rights and claims which the Volunteer has or which may hereafter accrue to the Volunteer and from any and all damages which may be sustained by the Volunteer directly or indirectly in connection with, or arising out of, the Volunteer’s exposure to such Animals.
By typing your name here, you are agreeing to the above liability waiver and certifying you are age 18 or older.*
Signature*

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