First and Last Name:
D.O.B./Age
Street Address
City:
State:
Zip:
Cell phone:
Email Address:
Allergies or physical restrictions:
How did you hear about Jeepin For Paws?
Why do you want to volunteer at Jeepin For Paws?
Are you fulfilling court ordered community service? If yes, what were your charges?
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)
Cleaning/Scooping Litter
Pet Transport
Foster care (please fill out foster app)
Special Events
When are you available to volunteer? (check all that apply)
Monday Evening
Tuesday Evening
Wednesday Evening
Thursday Evening
Friday Evening
Saturday Morning
Saturday Afternoon
Saturday Evening
Sunday Morning
Sunday Afternoon
Sunday Evening
Any additional comments:
In case of emergency, who should we contact? (name and phone #)
This Volunteer Waiver and Release of Liability ("Waiver") is executed by [Volunteer’s Full Name] ("Volunteer") on [Date], in favor of Jeepin For Paws, a nonprofit organization, its directors, officers, employees, and agents (collectively, "Jeepin For Paws").1. Acknowledgment of RisksVolunteer acknowledges and understands that volunteering with Jeepin For Paws may involve various risks, including but not limited to:Physical activities while caring for animals on Jeepin For Paws property, including but not limited to handling cats, cleaning enclosures, and lifting or moving supplies.Risks associated with transporting animals in Volunteer’s own vehicle or other forms of transportation.Potential hazards at Jeepin For Paws events held at various locations, which may require travel to and from the event locations.2. Assumption of RiskVolunteer freely and knowingly assumes all risks associated with the activities described above, as well as any other risks that may arise from Volunteer’s involvement with Jeepin For Paws.3. Waiver and ReleaseIn consideration of being permitted to volunteer, Volunteer, on behalf of themselves and their heirs, assigns, and personal representatives, hereby voluntarily releases, waives, and discharges Jeepin For Paws from any and all claims, demands, actions, or causes of action, whether known or unknown, arising out of or related to any injury, illness, death, or property damage that may occur while volunteering, transporting, or participating in any Jeepin For Paws events or activities.4. Medical TreatmentVolunteer consents to receive medical treatment deemed advisable in the event of an injury, accident, or illness while volunteering or participating in Jeepin For Paws activities. Volunteer agrees to pay for any and all medical expenses incurred in connection with treatment.5. IndemnificationVolunteer agrees to indemnify and hold harmless Jeepin For Paws from any and all claims, liabilities, damages, or costs, including reasonable attorneys' fees, arising out of Volunteer’s activities or negligence while participating in any activities associated with Jeepin For Paws.6. InsuranceVolunteer understands that Jeepin For Paws does not provide health, medical, or automobile insurance for any volunteers. Volunteer is encouraged to have their own insurance coverage.7. Transportation AcknowledgmentVolunteer acknowledges that if they transport animals in their own vehicle, they assume full responsibility for any accidents, damages, or injuries that may occur during transport. Jeepin For Paws shall not be held responsible for any incidents occurring while Volunteer is transporting animals.8. Photographic ReleaseVolunteer grants Jeepin For Paws the right to use photographs or videos taken of them during volunteer activities for promotional or educational purposes without expectation of compensation.9. ConfidentialityVolunteer agrees to keep confidential any proprietary or sensitive information learned while volunteering with Jeepin For Paws.10. Governing LawThis Waiver shall be governed by and construed in accordance with the laws of the state of Virginia.11. Entire AgreementThis Waiver contains the entire agreement between the parties. If any portion of this Waiver is deemed invalid, the remaining provisions shall continue in full force and effect.By signing below, Volunteer acknowledges that they have read, understood, and voluntarily agree to the terms and conditions stated above.
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 Jeepin For Paws
Anything else you would like to say, please note it here:
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