Lost Paws Volunteer Application

Lost Paws Animal Rescue Volunteer Application
First & Last Name:*
D.O.B./Age*
IE: 11/5/1981 35 years old
Please note if you are under 18 that you must be accompanied by a parent/guardian while volunteering
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone:*
Secondary Phone:
E-mail*
Allergies or physical restrictions:*
How did you hear about Lost Paws?
Why do you want to volunteer at Lost Paws?*
Do you work with any other rescue organizations?*

YesNo
If so, please give contact information for that organization including name and phone #:
Please list any pets you currently own (or have owned in the past 5 years).
Name, Breed, Age, Spay/Neuter, Declawed, Reason no longer with you

CURRENT pet information

Rows	Name	Breed	Spay/Neuter	Declawed?	Notes:
1
2
3
4
5

Animal Experience: (check all that apply)

Veterinary HospitalBoarding FacilityFoster HomeDog GroomingCat GroomingShelter WorkTraining/ObediencePet SittingFarm AnimalsOther
If you would like to comment more on your experience with the above, please do so here:
If you listed other, please explain:
Other Experience, Special Skills, Strengths, Talents: (check all that apply)

ComputersManagementCraftsWorking w/childrenGraphic ArtsWoodwork/CarpentryPaintingPhotographyWritingSecretarialFund-raisingPublic SpeakingOther
If you would like to comment more on your experience with the above, please do so here:
If you listed other, please explain:
Volunteer Work Preferences: (check all that apply)

Cage CleaningPet TransportClerical/OfficeCat FosterDog FosterComputer/WebsiteSpecial EventsCommunity OutreachOther
When are you available to volunteer? (check all that apply)

Weekday MorningsWeekday EveningsWeekend MorningsWeekend Evenings
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 Lost Paws Animal Rescue (LPAR). WHEREAS, the Volunteer has voluntarily contacted LPAR and has expressed an interest in working with animals in the care and custody of LPAR. In consideration of LPAR’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 cats and dogs pose and have elected to view and/or interact with one or more cats and dogs in the care of LPAR voluntarily. The volunteer knowingly assumes all risks that exposure to animals may pose, including but not limited to serious bodily injury and/or death. 2. THE VOLUNTEER HEREBY WAIVES, RELEASES DISCHARGES, HOLD HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINST LPAR, 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 Lost Paws Animal Rescue.
IF APPLICANT IS A MINOR
Anything else you would like to say, please note it here:
Should be Empty: