First and Last Name:
D.O.B.
Street Address
City:
State:
Zip:
Home Phone:
Cell phone:
Email Address:
Allergies or physical restrictions:
Are you volunteering for community service or school credits?
Yes
No
How did you hear about ElderPaw Rescue?
Why do you want to volunteer with ElderPaw Rescue?
Do you work with any other rescue organizations?
Yes
No
If so, please list them and what you do there.
If you have pets in the home, please list species and how many of each.
Animal Experience: (check all that apply)
Animal Shelter
Animal Rescue
Veterinary Hospital
Boarding Facility
Foster Home
TNR (Trap/Neuter/Return)
Grooming
Training/Obedience
Pet Sitting
Farm Animals
Other
If you listed other, please explain:
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)
Woodwork/Carpentry
Computers/Web development
Graphic Arts
Photography
Public Relations
Social Media Management
Volunteer Management
Crafts
Painting
Grant Writing
Secretarial
Fund-raising
Other
If you listed other, please explain:
If you would like to comment more on your experience with the above, please do so here:
Volunteer Work Preferences: (check all that apply)
Animal Care (cleaning, feeding, socializing)
Pet Transport
Clerical/Office
Foster care (please fill out foster app)
Computer/Website
Special Events
Community Outreach
Other
When are you available to volunteer? (check all that apply)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
As needed
Morning
Afternoon
Evening
Would you be willing to volunteer off the rescue premises?
Yes
No
Reference #1 (Name, phone # and relationship to self)
Reference #2 (Name, phone # and relationship to self)
Any additional comments:
In case of emergency, who should we contact? (name and phone #)
This volunteer agreement (“Agreement”) is entered into as of the date set forth below by ElderPaw Rescue (EPR). WHEREAS, the Volunteer has voluntarily contacted EPR and has expressed an interest in working with animals in the care and custody of EPR. In consideration of EPR’s agreement to allow the volunteer to view and/or interact with such animals, 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 animals pose and have elected to view and/or interact with animals in the care of EPR voluntarily. The volunteer knowingly assumes all risks that exposure to animals may pose, including but not limited to bodily injury and/or death. 2. THE VOLUNTEER HEREBY WAIVES, RELEASES DISCHARGES, HOLD HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINT EPR, 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 animals.
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 Last Resort Rescue.
Anything else you would like to say, please note it here:
Submit Form
Should be Empty: