Runnin' WJ Ranch Volunteer
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best Contact Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
2nd Best Contact Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Age
Height
T-Shirt Size
Adult Small
Adult Medium
Adult Large
Adult XLarge
Adult 2X
Adult 3X
Adult 4X
Returning Volunteer
Yes
No
Military Service? If yes, what branch?
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Emergency Medical Information and Treatment
Emergency Contact Person
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Volunteer
Preferred Physician
Physician Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Medical Facility
Insurance Company
Insurance Policy/Group #
Describe any medical conditions requiring special precautions or treatment (ie: Diabetic, Severe Allergies, Asthma):
In the event emergency medical aid or treatment is required due to illness or injury on the property of this agency, I authorize Runnin' WJ Ranch to: 1. Secure and retain medical treatment and transport if needed. 2. Release my records upon request to the authorized or agency involved in the medical emergency treatment. This authorization includes x-ray, surgery, hospitalization, medication, and any treatment procedure deemed "lifesaving" by the physician. This provision will only be invoked if the person listed above cannot be reached.
I GIVE Consent
I DO NOT GIVE Consent
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Schedule Availability
Day(s) and shift(s) you will be available to volunteer: (click all that apply) The below schedule is only for those individuals who wish to work directly with our riders *Monday & Friday could change so please be flexible*
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
I would like to be considered for (Anyone working around our horses or with our riders must attend a volunteer training session.):
Horse Leader - Good horse experience REQUIRED
Sidewalker- No horse experience
Substitute List: If you cannot commit to at least one hour each week, then you may choose to be called to fill in for a weekly volunteer only if they are unable to make their scheduled time.
Yes
No
Other Volunteer Opportunities (When Available, Please Check All Interested In):
Mailouts
Events/Fundraisers
Building/Painting Projects
Facility & Ground Maintenance
Facility Cleaning & Organizing
Type a question
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
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Experience
Do you have experience working with children or adults with disabilities? If yes, please explain:
Do you have experience working with horses? If yes, please explain.
How did you hear about us?
Website
Facebook
Twitter
Radio
Magazine
Fundraiser
Word of Mouth
Other
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Background Check Information
Have you ever been arrested or convicted of a crime? If yes, please explain the nature of this crime in detail:
Are you currently on probation?
Yes
No
Is the charge a
Misdemeanor
Felony
Are you volunteering to receive community service hours?
Yes
No
Are you Community Service Hours Court Ordered?
Yes
No
How many hours?
Current Driver's License # & State
I currently do not have a drivers license
Check yes for no drivers license
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Photo Release, Liability Release, Confidentiality Aggreement
WARNING: UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE ANDREMEDIES CODE), A FARM ANIMAL PROFESSIONAL IS NOT LIABLEFOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN FARMANIMAL ACTIVITIES RESULTING FROM THE INHERENT RISKS OFFARM ANIMAL ACTIVITIES
For valuable consideration given and which is hereby acknowledged, the undersigned hereby grants to Runnin WJ Ranch permission to take or have taken still and moving photographs and films, including television pictures, and consents and authorizes Runnin WJ Ranch and its work, to use and reproduce the photographs, films or pictures, and to circulate and publicize the same by all means, including, without limiting the generality of the foregoing, newspapers, television media, brochures, pamphlets, instructional materials, books, social media, and clinical materials. With respect to the foregoing matters, no inducements or promises have been made to secure this signature to release other than the intention of Runnin WJ Ranch to use or cause to be used such photographs, films, and pictures for the primary purpose of promoting Runnin WJ Ranch to its work.
I GIVE consent photo use
I DO NOT GIVE consent for photo use
No person can be accepted for volunteer service until the participant has completed this form. If the participant is less than eighteen (18) years of age the parent or guardian must complete this form. Services will be under trained supervision and although every effort will be made to avoid any accident, NO LIABILITY can be accepted by any of the organizations concerned, including Runnin’ WJ Ranch.YES, I would like to participate or have my son/daughter participate as a volunteer. Iunderstand that NO LIABILITY can be accepted by any organization concerned with this service, including Runnin’ WJ Ranch in the event of any accident, which might occur. By typing your name in the box below you agree to the above liability release.
I agree to respect and observe privacy and confidentiality of the participants, volunteers and donors of the Runnin WJ Ranch Therapeutic Riding Center and not discuss or disclose any sensitive information about any person or their family. This includes posting to social media, taking photos for personal use of staff, volunteers, riders, or horses. By typing your name in the box below you agree to the above confidentiality agreement.
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