Volunteer Animal Rescue Application Form

First and Last Name:
D.O.B./Age
Street Address
City:
State:
Zip:
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:
Why do you want to volunteer at Bully Rescue of New Jersey Inc.?
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)

Veterinary HospitalBoarding FacilityFoster HomeDog GroomingCat GroomingShelter WorkTraining/ObediencePet SittingFarm AnimalsOther
If you would like to comment more on your experience with the above, please do so here:
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)

Shelter cleaningPet TransportDog WalkingClerical/OfficeFoster care (please fill out foster app)Computer/WebsiteSpecial EventsEducational ProgramsCommunity OutreachOther
When are you available to volunteer? (check all that apply)

WeekdaysWeekends
Reference #1 (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 Bully Rescue of New Jersey Inc.. WHEREAS, the Volunteer has voluntarily contacted Bully Rescue of New Jersey Inc. and has expressed an interest in working with dogs in the care and custody of Bully Rescue of New Jersey Inc. In consideration of Bully Rescue of New Jersey Inc.’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 Bully Rescue of New Jersey Inc. 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 Bully Rescue of New Jersey Inc., 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. If you are under the age of 18, you will need a parent or legal guardian to sign this form below. Thank you!
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 Bully Rescue of New Jersey Inc..
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