The Pines Horse Farm Volunteer Application Form

Full Legal Name
Age
Street Address
City:
State:
Zip:
Home 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 Pines Horse Farm & Sanctuary?
Why do you want to volunteer at The Pines Horse Farm & Sanctuary?
Are you comfortable haltering and leading horses? (Some may be hard to catch)
How would you approach a horse who doesn't like to be caught?
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)

Large Animal Veterinary HospitalHorse Boarding FacilityHorse Foster HomeShelter WorkHorse Training/ObedienceHorse OwnerOther
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)

ComputersManagementCraftsWorking w/childrenGraphic ArtsWoodwork/CarpentryPaintingPhotographyWritingSecretarialFund-raisingPublic SpeakingOther
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 TransportClerical/OfficeFoster care (please fill out foster app)Computer/WebsiteSpecial EventsEducational ProgramsCommunity OutreachOther
When are you available to volunteer? (check all that apply)

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Reference #1 (Name, phone # and relationship to self - please list NON IMMEDIATE family members)
Reference #2 (Name, phone # and relationship to self - please list NON IMMEDIATE family members)
Any additional comments:
In case of emergency, who should we contact? (name and phone #)
Once you are approved to volunteer, please understand that we cannot be liable for anyone that you bring to the farm who gets injured. The farm is a working operation and we have horses in all states of rehab. PLEASE use common sense when bringing visitors along. Always wear closed toe shoes, work boots or rain boots are most ideal for farm work.
This volunteer agreement (“Agreement”) is entered into as of the date set forth below by The Pines Horse Farm & Sanctuary. WHEREAS, the Volunteer has voluntarily contacted TPH&S and has expressed an interest in working with horses in the care and custody of TPH&S. In consideration of TPH&S's agreement to allow the volunteer to view and/or interact with such horses, 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 horses pose and have elected to view and/or interact with one or more horses in the care of TPH&S voluntarily. The volunteer knowingly assumes all risks that exposure to horses 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 TPH&S, 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 horses.
By writing your name here, you are agreeing to the above liability waiver.
By writing your name here, you are stating that you are a parent/guardian of the above applicant and you grant your permission for them to volunteer with The Pines Horse Farm & Sanctuary.
Should be Empty: