• Heroes on Horseback Logo

    Heroes on Horseback

    Volunteer Information Form
  • Is this an edit of your original Volunteer Information Form? If so, please fill out all of the information, even if it has not changed since your original submission.*
  •  -
  •  -
  • Date of Birth*
     - -
  •  -
  • Are you interested in any aspect of fundraising for our organization? This includes as a donor or volunteering for specific fundraising activities. Fundraising is an opt-in selection for our volunteers.
  • Can you jog 50 yards?*
  • Can You Lift 50 lbs?*
  • What Days Are You Available (please click all that apply)?*
  • What Times of Day Are Best For You?*
  • Check areas in which you are interested:*

  • PHOTO RELEASE: Do you consent to and authorize the use and reproduction by HEROES ON HORSEBACK of any and all photographs and any other audio/visual materials taken of me for promotional material, educational activities, exhibitions or for any other use for the benefit of the program?*
  • BACKGROUND INFORMATION: Have you ever been charged with or convicted of a crime?*
  • Do you authorize HEROES ON HORSEBACK to receive information from any law enforcement agency, including police departments and sheriff’s departments, of this state or any other state or federal government, to the extent permitted by state and federal law, pertaining to any convictions I may have had for violations of state or federal criminal laws, including but not limited to convictions for crimes committed upon children or animals. I understand that such access is for the purpose of considering my application as an employee/volunteer, and I expressly DO NOT authorize HEROES ON HORSEBACK, its directors, officers, employees or other volunteers to disseminate this information in any way to any other individual, group, agency, organization or corporation.*
  • CONFIDENTIALITY AGREEMENT: I understand that all information (written and verbal) about participants at HEROES ON HORSEBACK is confidential and will not be shared with anyone without the written consent of the participant or his/her parent/guardian in the case of a minor.*
  • Date*
     - -

  • GENERAL ACTIVITY RELEASE, ASSUMPTION OF RISK and WAIVER OF LIABILITY AGREEMENT

    This document waives important legal rights. Read it carefully before signing

    I AGREE for myself, and/or my child, my/our administrators and assigns, in consideration for my, and/or my child’s, participation in Heroes on Horseback activity of the following:

    I AGREE that I choose to participate voluntarily in Heroes on Horseback activities as a rider, handler or spectator. I am fully aware and acknowledge that horse sports and Heroes on Horseback activities involve inherent dangerous risks of accident, loss, and serious bodily injury including, but not limited to, broken bones, head injuries, trauma, pain, suffering or death (“Harm”). I fully understand that this release covers, but is not limited to, inherent risks of an equine activity which mean a danger or condition that is an integral part of an equine activity, including but not limited to, any of the following:

    The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine;
    The unpredictability of an equine’s reaction to sounds, sudden movement, unfamiliar objects, persons, or other animals;
    Hazards, including, but not limited to, surface or subsurface conditions;
    A collision with another equine, another animal, a person, or an object;
    The potential of an equine activity participant to act in a negligent manner that may contribute to injury, death, or loss to the person of the participant or to other persons, including but not limited to, failing to maintain control over an equine or failing to act within the ability of the participant.
     

    I AGREE that I/my child/my ward would like to participate in the Heroes on Horseback program. I acknowledge the risks and potential risks, however, I feel that the possible benefits to me/my child/my ward are greater than the risk assumed. I hereby, intending to be legally bound for myself, my heirs and assigns, executors or administrators waive and release forever all claims for damages against Heroes on Horseback, it’s Board of Directors, instructors, therapists, aides, volunteers, employees, facility owners, NCM Equestrian LLC  and affiliated organizations for any and all injuries and/or losses I may sustain while participating in the Heroes on Horseback program including activities occurring outside of the scope of the program itself, including, but not limited to transportation, care giving, horse exercising etc.

    By signing below, I ACKNOWLEDGE that I enter into this release after having read the same, and place my signature hereto of my own free voluntary act and deed. By signing below, I represent to Heroes on Horseback that I fully understand its contents, that I do not need any further explanation, and I waive any further explanation.

    I AGREE to assume all risks of Harm to me and/or my child, and specifically agree to the SOUTH CAROLINA LIABILITY LAW

    regarding equine/ farm animal activity liability:  Under South Carolina Law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in an equine activity resulting from an inherent risk of equine activity, Pursuant to Article 7, Chapter 9 of Title 47, Code of Laws of South Carolina, 1976.

    ACCEPTED BY: (if under the age of 18 years old, there must be a legal guardian signature below)

  • Date*
     - -
  • Should be Empty: