StirrUp Purpose Volunteer Application Form

StirrUp Purpose

at Faith Run Farms

60575 Billadeau Rd, Bend OR 97702

541-410-0164
Volunteer Application

Thank you for your interest in volunteering at StirrUp Purpose. In addition to this form, please complete the Hold Harmless Agreement/Release and Waiver of Liability form Please let us know a little about you!
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Age*
Gender*
Phone Number*
Can you receive texts on this phone?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Height (ft.inches)*
Weight (lbs)*
Applicant School/Institution/Employer:*
Are you:*

MinorIndependent AdultAdult with Legal guardianVeteran
Emergency Contact Name:*
Emergency Contact Relationship to Applicant:*
Emergency Contact Phone: *
Please enter a valid phone number.
If the Applicant is a minor or an adult with a legal guardian, please complete the following information.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Parent/Guardian Email
example@example.com
What is the Applicant's experience level with horses?*

NoneOne time pony, sleigh or trail rideSome riding lessons/beginnerIntermediate riderAdvanced/Experienced riderOther
Tell us about any health conditions we should be aware of:
What type of volunteering are you interested in?*

SidewalkerHorse HandlerUnmounted SchoolerMounted SchoolerFacilityAdministrative
What days and times are you available to help out?*
How did you hear about us?*

Current or past participantWebsite/Social MediaCommunity OrganizationOther
I do hereby attest that this information is true, accurate and complete to the best of my knowledge.
Signature of Applicant or Legal Guardian of Applicant (typed name indicates signature):*
Date*

MonthDayYear
Date
Should be Empty: