First and Last Name:
D.O.B./Age
Street Address
City:
State:
Zip:
Home Phone:
Work Phone:
Cell phone:
Email Address:
Employer/Job Title:
Allergies or physical restrictions:
Please list any pets you currently own (or have owned in the past).
Animal Experience: (check all that apply)
Veterinary Hospital
Boarding Facility
Foster Home
Dog Grooming
Cat Grooming
Shelter Work
Training/Obedience
Pet Sitting
Farm Animals
Other
If you would like to comment more on your experience with the above, please do so here:
Other Experience, Special Skills, Strengths, Talents: (check all that apply)
Computers
Management
Crafts
Working w/children
Graphic Arts
Woodwork/Carpentry
Painting
Photography
Writing
Secretarial
Fund-raising
Public Speaking
Other
If you would like to comment more on your experience with the above, please do so here:
Volunteer Work Preferences: (check all that apply)
Shelter cleaning
Pet Transport
Dog Walking
Clerical/Office
Foster care (please fill out foster app)
Computer/Website
Special Events
Educational Programs
Community Outreach
Puppy overnight stay
When are you available to volunteer? (check all that apply)
Weekdays
Weekends
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 Aussome Aussies Inc . WHEREAS, the Volunteer has voluntarily contacted Aussome Aussies and has expressed an interest in working with dogs in the care and custody of Aussome Aussies. In consideration of this 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 Aussome Aussies 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 Aussome Aussies, 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. addition to that Aussome Aussies a NC 501(c) (3) charitable organization does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, subcontractors, vendors, and clients.
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 Last Resort Rescue.
Anything else you would like to say, please note it here:
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