CRC Volunteer Application Form

Position Applying for (if applicable)

First and Last Name:

Age

I am under 18 years old

yesno

If under the age of 18, please upload parent consent letter.

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I am under 16 years old

yesno

NOTICE: If under the age of 16, a parent will need to accompany the volunteer at the clinic.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone:

Work Phone:

Cell phone:

Email Address:

Employer/Job Title:

May we contact for reference:

YesNoN/A

If yes, please provide name and phone # of employer:

Allergies or physical restrictions:

How did you hear about the Pearland Canine Resource Center?

Why do you want to volunteer at the Pearland CRC?

Are you needing Signatures for Volunteer Hours?

YesNo

If yes, please upload Volunteer hours form.

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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 own (or have owned in the past).

Animal Experience: (check all that apply)

If you would like to comment more on your experience with the above, please do so here:

If you listed other, please explain:

Other Experience, Special Skills, Strengths, Talents: (check all that apply)

If you would like to comment more on your experience with the above, please do so here:

If you listed other, please explain:

Volunteer Work Preferences: (check all that apply)

When are you available to volunteer? (check all that apply)

WeekdaysWeekends

Reference #1 (Name, phone # and relationship to self)

Reference #2 (Name, phone # and relationship to self)

Reference #3 (Name, phone # and relationship to self)

Any additional comments:

In case of emergency, who should we contact? (name and phone #)

This volunteer agreement (“Agreement”) is entered into as of the date set forth below by the Pearland Canine Resource Center (CRC). WHEREAS, the Volunteer has voluntarily contacted the CRC and has expressed an interest in working with dogs in the care and custody of the CRC. In consideration of WAR’s agreement to allow the volunteer to view and/or interact with such dogs, 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 dogs pose and have elected to view and/or interact with one or more dogs in the care of WAR voluntarily. The volunteer knowingly assumes all risks that exposure to dogs 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 AGAINT WAR, 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 an 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 dogs.

By writing your name here, you are agreeing to the above liability waiver.

By writing your name here, you are stating that you are the parent/guardian of the above applicant and you grant your permission for them to volunteer with the Pearland CRC.

Anything else you would like to say, please note it here: