Volunteer Application/Agreement

Today's Date*

MonthDayYear

Full Name*

First NameLast Name

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Home Phone

Area CodePhone Number

Mobile Phone*

Area CodePhone Number

Date of Birth*

MonthDayYear

I work*

Full Time JobPart Time JobOther

I can realistically help _____ hours per week*

I have health insurance*

YesNo

If you have health insurance, please note insurance company

Have you worked/volunteered with a rescue, humane society, shelter, or animal care?*

YesNo

If yes, please list organization(s)

Is your involvement with the organization(s) current?

YesNo

If I am accepted as a volunteer, I agree to adhere to SCK procedures and policies.*

Routine Maintenance - Cage Cleaning, Pet Laundry

	1	2	3	4	5

1 is Not Interested, 5 is Very Interested

Errands - Backfilling Pet Store, Donation Pick-Up, Etc.

	1	2	3	4	5

1 is Not Interested, 5 is Very Interested

Feral Cats - Colony Assistance, Feeding, Trapping, Recovery Person, Trap Sterilization, Training, etc.

	1	2	3	4	5

1 is Not Interested, 5 is Very Interested

Cat Chauffeur - Feral Cat Clinic Transports, Adoption Pet Store Transports, Animal Transports, Vet Appointments, etc.

	1	2	3	4	5

1 is Not Interested, 5 is Very Interested

Volunteers are an important part of SCK and we welcome those who wish to participate in our programs. Steps to becoming a SCK volunteer:

You must have an application on file.
Anyone that will be volunteering must willingly sign this form.
You must meet with a SCK member to discuss tasks, procedures, policies, etc.

Today's Date*

MonthDayYear

Full Name*

First NameLast Name

Date of Birth*

MonthDayYear

I certify that as of today's date I am over 18 years of age.*

YesNo

If between 16-18 years old: Ideally a Guardian will be present during volunteer activities; however, we understand this may not always be possible. It is required the Guardian information be provided on this application and Guardian shall accompany minor on first meeting with a SCK Representative and is required to sign the Hold Harmless Agreement within this application as well as at first meeting. I have read and agree to comply if applicable.

YesNo

Guardian's Name

First NameLast Name

Guardian's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Guardian's Phone

Area CodePhone Number

Guardian's Email Address

Zoonotic & Animal Diseases: I have read and am encouraged to print and keep the digital information regarding the potential exposure to common Zoonotic Diseases carried by Dogs and Cats including Rabies, Distemper, and Intestinal Parasites.

Acknowledgement of Zoonotic and Animal Diseases.*

Tetanus Advisory: You are strongly urged to have a current tetanus vaccination to protect yourself should you be cut, scratched or otherwise injured in such a way that tetanus infection could threaten your health.

Acknowledgement of Tetanus Advisory*

Release of Liability: I understand that while volunteering for Second Chance Kitty. (Hereinafter referred to as SCK), I must comply with all requirements, rules and regulations established by SCK.

I understand that any and all information such as the names, address and phone numbers of owner surrenders, adopters, and cruelty cases I may have knowledge of are to be kept private and confidential. This information is not to be released to the general public, or given to potential adopters.

I understand that SCK rescues stray and unwanted animals, almost exclusively cats. Because many of these animals come from unknown origins and backgrounds, SCK makes no claims or representations regarding the health, temperament or disposition of animals. I understand these animals may be unpredictable in their behavior and may bite, scratch or otherwise cause harm whether intentionally or unintentionally. I also understand the status of the health and vaccinations (including rabies) is often unknown. In signing this agreement I am verifying that I understand and assume all risks involved to myself, family, friends, and personal pets in volunteering with SCK, included but not limited to; being scratched, injured, frightened or bitten by the animals in connection with my volunteer activities with SCK.

I indemnify, defend and hold SCK, their officers, board members and other volunteers harmless from any and all claims, lawsuits, injuries, property damages, all actions, causes of actions, claims, demands, losses or rulings, costs, expenses or compensation sustained by any animal or any person in connection (including travel) with my volunteer activities with SCK. I understand and assume the risk, and agree to be legally bound by the terms and conditions stated herein. This waiver includes myself, all of my family members and decedents forever from seeking any legal action against SCK.

I have read and understand this notice and agree to hold SCK harmless should any such circumstances arise as mentioned above.

Photography Release: I agree to allow pictures of myself to be used, without compensation, for the purpose of the promotion and publicity related to SCK.

Signature*

Date

MonthDayYear

Guardian's Signature