STRIDE Volunteer Registration

STRIDE Volunteer Registration

Volunteer registration form for STRIDE Equine Therapy. Please complete all applicable sections; parent/guardian information and signature are required if the volunteer is under 18.
Volunteer Contact Information
Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Preferred Contact Method
Parent/Guardian Information and Permission
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Volunteer
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Parent/Guardian Address (if different from Volunteer)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Details
Emergency Contact Full Name

First NameMiddle NameLast Name
Relationship to Volunteer
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number or Email
Please enter a valid phone number.Format: (000) 000-0000.
Health and Medical Information
Health conditions or medical diagnoses
Allergies

Other
Physical limitations or medically relevant precautions
Availability
Available days of the week
Available times
Hours available per week
Desired start date

MonthDayYear
Date
Volunteer Interests and Experience
Areas of Interest

Other
Horse Experience Level
Experience Working with Individuals with Disabilities
Skills, Certifications, or Relevant Experience Details
Preferences and Limitations
Preferences, restrictions, or limitations we should know about
Areas you prefer not to assist with

Other
Background and References
Have you ever been convicted of a criminal offense?
If yes, please provide a brief explanation
Reference Information
Additional background details or context
Reference notes or special instructions
Consent, Waiver, Media Release, Confidentiality, and Handbook Acknowledgment
Volunteer Orientation & Required Documents (Required)
Signatures
Volunteer Signature
Date Signed

MonthDayYear
Date
Parent/Guardian Signature
Parent/Guardian Date Signed

MonthDayYear
Date
Should be Empty:

STRIDE Volunteer Registration

Volunteer Contact Information

Parent/Guardian Information and Permission

Emergency Contact Details

Health and Medical Information

Availability

Volunteer Interests and Experience

Preferences and Limitations

Background and References

Consent, Waiver, Media Release, Confidentiality, and Handbook Acknowledgment

Signatures