Transport Driver Volunteer Application

Transport Driver Volunteer Application
Your Full Name*

First NameMiddle NameLast Name
Your Primary Phone #*
Please enter a valid phone number.
Your Email Address*
example@example.com
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Make, model and color of your vehicle.*
This info will be used so rescues know who to look for when meeting up for transports.
Upload Your Driver's License*

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Will any other adults (18+) be riding in the car with you during transport?*

YesNoNot sure
Name of other Passenger*

First NameMiddle NameLast Name
Passenger Phone Number*
Please enter a valid phone number.
Upload Passenger Driver's License*

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WAIVER OF LIABILITY

The Humane Society of St. Joseph County takes great measuresto maintain a safe environment for its staff, volunteers and visitors.Unfortunately, there is a possibility that an accident or injury may occurduring your volunteer service. Please read the statement below, sign and datethis form to indicate your understanding and agreement. *Please note: Eachvolunteer, parent, guardian, or minor must have a separate waiver filled outand signed. Please do not put more than one volunteer on a sheet.
I, First Name* Last Name* , agree to follow all safety precautions in connection to my volunteer service for the Humane Society of St. Joseph County. I hereby release and forever discharge the Humane Society of St. Joseph Count and its officers, directors, employees and contractors from any liability in connection with any costs, injury, or losses incurred directly or indirectly, during my time volunteering at the shelter, including any negligence of the Humane Society of St. Joseph County and its Officers, Directors, Employees and Contractors.
Volunteer's Name*

First NameMiddle NameLast Name
Volunteer's Date of Birth*

MonthDayYear
Date
Volunteer Signature*

Clear
Today's Date*

MonthDayYear
Date
Should be Empty:

Transport Driver Volunteer Application

WAIVER OF LIABILITY