Junior Volunteer Application » New Rochelle Humane Society: Dog and Cat Adoptions

Junior Volunteer Application

This form is to be read and completed by a parent/legal guardian.
I am the:
Parent Legal Guardian
Parent / Legal Guardian's name(required)

Child/children's details

I give permission for the following child/children to participate in the New Rochelle Humane Society’s activities:
Child's name(required)
Age(required)
Date of Birth(required)
Child's name
Age
Date of Birth

Address(required)
City(required)
State(required)
Zip(required)
Daytime Phone(required)
Cell Phone(required)
Emergency Phone(required)
Email(required)
School(s) child/children currently attending(required)
Describe experience with dogs/cats:(required)
Animals in your household:(required)

Permission and Release of Liability

In consideration of this opportunity to volunteer, I agree to the following terms and conditions, intending to be legally bound by them:
1. My child/children will abide by the mission, rules, regulations, policies and programs of the New Rochelle Humane Society.
2. I assume the risks of my child/children being bitten, scratched, injured or frightened by the cats, kittens, dogs, puppies and other animals in connection with my volunteer work for the New Rochelle Humane Society.
3. The New Rochelle Humane Society is not liable for any injuries, damages, liabilities, cost or expenses whatsoever, which my child/children might suffer or sustain in connection with the performance of their volunteer activities for the New Rochelle Humane Society.
4. I hereby release and indemnify, defend and hold harmless the New Rochelle Humane Society’s directors, officers, employees, agents, and volunteers and their heirs, successors, assistants and personal representatives from and against liability.
5. I understand and agree that the New Rochelle Humane Society may refuse volunteer applications for any reason.
6. I have accurately completed this volunteer application.
I have read and agree to the above terms and conditions

cforms contact form by delicious:days