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  • Horse Rescue Volunteer Application Form

  • Volunteer Information

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  • CONFIDENTIALITY AGREEMENT FOR VOLUNTEERS

     

    The confidentiality of our clients is protected by Federal Law.  Federal Regulation 42 CFR Part. 2, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and 45 CFR, pts 160 and 164 prohibits you from disclosing information and identifying clients served by this program.  Federal Law prohibits acknowledgement that a person is a client or has been a client receiving services from our program.  The regulations apply to Volunteers on duty/not volunteering.  Persons convicted of violations of confidentiality regulations are subjected to a fine of $500 for first offense and up to $5,000 for each subsequent offense.


    I hereby acknowledge that I have read and understand the above confidentiality regulations and agree to adhere to these federal regulations and all program policies regarding client confidentiality.

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  • Release of Liability 

    The undersigned do hereby release, forever discharge and agree to hold Warhorse Liberation and Landlord harmless from and against any and all liability, claims, demands, lawsuits, and expenses arising from personal injury, sickness, death, or property damage of any nature whatsoever which may be incurred or suffered by the undersigned and or the participant (if participant is under 18, or 18 and older) while attending the above activity. Furthermore, the undersigned hereby assume all risk of personal injury, sickness, death, damage and expense arising from the undersigned’s or participant’s (if participant is under 18, or 18 and older) participation in all activities, including recreation and work activities involved in the above activity. 

    The undersigned further hereby agree to indemnify and hold Warhorse Liberation, the above named agency, and their respective members, directors, employees, and agents (collectively, the ‘indemnities’), harmless from and against any and all claims, demands, actions, lawsuits and liabilities, including attorney’s fee and expenses sustained by the indemnities as the result of the negligent, willful, or intentional acts of the undersigned and/or participant (if participant is under 18, or 18 and older). 

    If participant is under 18 years of age: We (I) are the parent(s) or legal guardian(s) of the participant, and hereby grant permission for ____________________________________ to participate fully in the above activity and all of its undertakings, and hereby give our permission to take said participant to doctor or hospital and hereby authorize medical treatment, including but not limited to emergency surgery; and, we fully and completely assume responsibility for all medical bills. Furthermore, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, I (we) assume all responsibility and transportation costs.

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  • WARNING!!! 

    UNDER SOUTH DAKOTA LAW AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES 

    PURSUANT TO SDCL 42-11-2

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  •  RISK OF INJURY 

    Realizing that while participation in a horse activity there is inherent danger and risk of injury and/or death, I certify that I will not hold the sponsoring organizations and property owners, nor any of its agents, responsible or liable for any injuries while participation in the program nor while traveling to or from the program.

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  • Client Safety Contract 

    ● Abide by ranch policy – respect for fellow humans, respect for animals, respect for ranch buildings, and property. 

    ● Act in a responsible manner at all times while at the ranch. 

    ● Follow all instructions given by Board Members and ranch staff.

    ● Know how to get help in an emergency. 

    ● Wear appropriate clothing , shoes, or boots 

    ● Sign an information sheet and informed consent form before participating in ranch activities. 

    1. Shoes should be close toed so that toes are not exposed. Boots are best, but smoothed soled shoes will help. Sandals and ‘’slide’’ are DANGEROUS and not allowed. 

    2. Your shirt should be comfortable and washable. Sleeves help to prevent sunburn. 

    I have read and understand the safety rules. I agree to abide by safety regulations and any additional instructions, written or verbal, provided by the therapist and/or staff. 

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  • Photo Release 

    Photo Release not required to participate. 

    I,

  • do hereby grant Warhorse Liberation the non exclusive and irrevocable right and license to make, edit and use videos, photographs and/or comments for educational and promotional purposes. 

    I release Warhorse Liberation from any and all claims of payment for performance rights. residuals, or damages for libel, slander, invasion of privacy, or any claim based on the use of said material. 

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