First and Last Name
What do you like to be called?
D.O.B./Age (Are you over 18 years old?)
Yes or NO
Mailing Address/Physical Addres:
Address on Photo Match volunteer interest form? Yes or NO
City:
State:
Zip:
Home Phone:
Work Phone:
Cell phone:
Email Address:
Employer/Job Title:
If yes, please provide name and phone # of employer:
Allergies or physical restrictions:
Do you have a valid drivers license
Yes
NO
How did you hear about Rustic Rover Rescue?
Why do you want to volunteer at Rustic Rover Rescue?
Do you work with any other rescue organizations?
Yes
No
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 10 years).
Do you foster ?
Animal Experience: (check all that apply)
Veterinary Medicine
Boarding/Kennel work
Fostering
Grooming
Shelter Work
Training/Obedience
Pet Sitting
Farm Animals
Other
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)
Computers
Management/leadership skills
Arts/Crafts
Working w/children, seniors or special needs
Graphic Arts/web-sites
Woodwork/Carpentry
Photography
Writing/grant writing
Secretarial/newletters
Fund-raising/marketing
Public Speaking/Public Relations
Legal/Professional Degree
Electric/Plumbling
Accounting/banking
CDL/ pilot's license (certificate)
Other
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)
Kennel cleaning/laundry
Pet Transport
Dog Walking/Watching
Clerical/Office
Foster care (please fill out foster app)
Computer/Website
Adoption/Special Events
Educational Programs
Doggy Dog Out program
Other
When are you available to volunteer? (check all that apply)
Weekdays
Weekends
Other
Reference #1 (Name, phone # and relationship to self)
Reference #2 (Name, phone # and relationship to self)
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 Rustic Rover Rescue & Lodge Inc. WHEREAS, the Volunteer has voluntarily contacted RRR&L Inc. and has expressed an interest in working with animals in the care and custody of RRR&L. In consideration of RRR&L’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 dogs pose and have elected to view and/or interact with one or more dogs in the care of RRR 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 AGAINT RRR, 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 dogs.
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 Rustic Rover Rescue.
Anything else you would like to say, please note it here:
Submit
Should be Empty: