H.E.A.R.T. ANIMAL RESCUE
VOLUNTEER APPLICATION
NAME: ______
Address: ______City ______
State ______Zip ______Phone: ______
Email: ______
Age: ______Date of Birth: ______
Volunteers must be at least 12 years old. A volunteer younger than 18 years old must be accompanied by a parent or legal guardian volunteer who is at least 18 years of age at all times. Both parent and minor child must complete a volunteer application.
Volunteer Relationships
If you will be volunteering with someone else (such as a parent, minor, spouse, friend, etc).
Name: ______
Relationship: ______
Name: ______
Relationship: ______
Emergency Contacts
Name: ______
Relationship: ______Phone: ______
Name: ______
Relationship: ______Phone: ______
I am willing to:
______Transport animals (requires using your own vehicle and gas)
______sell merchandise at booths
______maintain kennels and playpens (meaning clean up after dogs if needed, keep clean water readily available etc)
______help set up at events
______help tear down at events
______work the informational desk (you must be fully versed in our rescue policies to answer questions concerning the rescue)
______help the fundraising committee in planning events (I will direct you to April Madr our fundraising coordinator)
______travel to local shelters to take photographs and network animals (this is done as a group – a board member, the president or committee chair will be in charge. This does not include PAWS. You must complete formal training with them in order to volunteer at their facility)
Waiver of Liability and Agreement to Indemnify
THE ABOVE LISTED acknowledges that he/she desires to perform certain services (collectively, the "Services") for H.E.A.R.T. Animal Rescue Inc., a Florida nonprofit organization (HAR). The above listed further understands and acknowledges that certain risks may be associated with performing the services.
By signing my name below, I, as a volunteer for the HAR agree on behalf of myself and our agents, attorneys, legatees, successors, and assigns that we shall fully and generally be deemed to have renounced to, released and discharged HAR and each of its agents, attorneys, employees, officers, directors, successors and assigns from any and all liability, claims, charges, actions, causes of action and defenses of any nature whatsoever that arise as a result of my actions or interactions while performing volunteer functions for HAR. This is a full general release and prevents me, among other things, from making a claim against, suing, attaching the property of or prosecuting HAR and each of its agents, attorneys, officers, directors, successors and assigns for damages for death, personal injury or property damage which I may sustain or cause as a result of his or her participation as a volunteer at HAR. This release is also intended to discharge in advance HAR and each of its agents, attorneys, employees, officers, directors, successors and assigns from and against any and all liability, including for negligent actions, arising out of or connected in any way with my participation as a HAR volunteer.
I FURTHER UNDERSTAND THAT ANIMALS ARE UNPREDICTABLE IN NATURE AND THAT SERIOUS INJURIES OR PERSONAL PROPERTY DAMAGE OCCASIONALLY OCCUR DURING THE HANDLING OF SUCH ANIMALS. I FURTHER UNDERSTAND THAT IN MANY INSTANCES HAR DOES NOT KNOW THE COMPLETE MEDICAL HISTORY OF ITS ANIMALS AND THAT THESE ANIMALS MAY HAVE UNKNOWN INFIRMITIES. I ACKNOWLEDGE BY SIGNING BELOW THAT HAR MAKES NO REPRESENTATIONS CONCERNING ANY ANIMAL’S EXPOSURE TO RABIES OR OTHER DISEASES. KNOWING THE RISKS OF
PARTICIPATION, NEVERTHELESS, I HEREBY AGREE THAT I ASSUME THOSE RISKS AND RELEASE AND HOLD HARMLESS HAR AND EACH OF ITS AGENTS, ATTORNEYS, DIRECTORS, OFFICERS, SUCCESSORS AND ASSIGNS WHO (THROUGH NEGLIGENCE OR CARELESSNESS) MIGHT OTHERWISE BE LIABLE TO ME (OR OUR HEIRS OR ASSIGNS) FOR DAMAGES.
I expressly agree that this waiver, release, and assumption of risk is intended to be as broad and inclusive as permitted by the laws of Florida and that if any portion hereof is held invalid, it is agreed that the balance, notwithstanding, continue in full legal force and effect.
I attest that I am eighteen (18) years old or older, and I am physically fit and have no known conditions which prohibit participation as a volunteer at HAR.
Or that I am between the the ages of twelve (12) and seventeen (17) and that I have a parent or legal guardian who is or will be an active volunteer at all times with me.
I agree to follow all laws, rules, and guidelines, regulations, policies, procedures, and ethics of HAR. I understand that my failure to do so will result in the termination as a volunteer. I understand that in the event of an injury, I must immediately report to the HAR manager on duty.
I also agree that HAR and its agents and employees may use my photograph in future promotions.
Due to the nature of the work, volunteers may encounter confidential information in the computer system, on printed documents, or in conversations between board members, volunteers and customers. Each volunteer is required by law to protect the confidentiality of any person’s identity, address, phone number, and/or personal details from all who don’t have a legitimate reason and authorization for the information. In addition, HAR seeks to protect the privacy of individuals that are customers, donors, adopters or potential adopters of the HAR. Failure to protect such information is a violation of HAR policy and could result in disciplinary action, including termination as a volunteer as well as criminal, civil and/or civil rights liability.
By signing below, the above listed acknowledges that he/she has read and fully understands the contents of this Waiver of Liability and Agreement to Indemnify. This Waiver of Liability and Agreement to Indemnify shall continue in full force and effect until terminated in writing and in the event of such termination shall remain applicable to all matters occurring or first arising on or before the date of such termination regardless of such termination.
Printed Name of above listed: ______
Signature of above listed: ______
Date: ______
If above listed is minor child, I ______as the parent or guardian of the minor child accept all statements and agree to all statements of the Waiver of Liability and Agreement to Indemnify.
Printed Name of Parent/Guardian: ______
Signature of Parent/Guardian: ______
Date: ______