First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Alt Email

Are you at least 18 years old?*
Choose one: Yes No

Name of parents (for those under 18):

What is your purpose for volunteering

What are you interested in doing?
Choose all that apply: Dog walking/feeding/care/cleaning Assist at events Pregnant/Whelping females Transport Cat care/feeding/cleaning Computer/Clerical Fundraising Yard work

Advisory: You are strongly urged to have a current tetanus vaccination to protect yourself should you be cut, scratched or otherwise injured in such a way that tetanus infection could threaten your health. I have read this and have been advised. *
Choose one: I Agree

I will abide by the mission, rules, regulations, policies and programs of Wags and Whiskers Pet Rescue, hereinafter referred to as “WAGS AND WHISKER’S PET RESCUE”, while I am a volunteer. I also agree to observe and follow all signs and instructions posted inside the shelter building of WAGS AND WHISKER’S PET RESCUE.*
Choose one: I Agree

I agree to allow pictures of myself to be used, without compensation, for the purpose of the promotion and publicity related to WAGS AND WHISKER’S PET RESCUE and possibly posted on social media sites.*
Choose one: I Agree

If I stop being a volunteer for WAGS AND WHISKER’S PET RESCUE for any reason, or upon the request of WAGS AND WHISKER’S PET RESCUE or its representatives at any time, I will promptly return all of WAGS AND WHISKER’S PET RESCUE’s supplies, equipment, records, money and other items in good clean condition.

I understand that the activity of working with shelter animals is hazardous and involves contact with animals that may be unpredictable. As such, WAGS AND WHISKER’S PET RESCUE cannot be held liable for injuries or accidents that may occur as a result of working with the animals. I assume the risks of being bitten, scratched, injured or frightened by cats, kittens, dogs and puppies, and any infections or complications that may occur as a result, in connection with my volunteer work for WAGS AND WHISKER’S PET RESCUE. WAGS AND WHISKER’S PET RESCUE is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with the performance of my volunteer activities for WAGS AND WHISKER’S PET RESCUE, unless they are the result of WAGS AND WHISKER’S PET RESCUE’s gross negligence or intentional misconduct. I will indemnify, defend and hold WAGS AND WHISKER’S PET RESCUE harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any companion animal or any person in connection with my intentional misconduct or grossly negligent performance of volunteer activities for WAGS AND WHISKER’S PET RESCUE, or my breach of WAGS AND WHISKER’S PET RESCUE’s rules, regulations, policies and programs.*
Choose one: I Agree

I understand that I may be exposed to canine and/or feline illness and disease and that it is also possible that I could indirectly expose my own pets to such illness and disease. *
Choose one: I Agree

I agree that if I see any dangerous situation at the shelter I will notify the WAGS AND WHISKER’S PET RESCUE’s Shelter Manager in writing immediately.*
Choose one: I Agree

I understand and agree that WAGS AND WHISKER’S PET RESCUE may refuse volunteer applications for any reason.*
Choose one: I Agree

In consideration of WAGS AND WHISKER’S PET RESCUE offering this volunteer opportunity, I/We agree to the following, intending to be legally bound:

I acknowledge that there are risks that the child(ren) could be bitten, scratched, injured or frightened by the dogs/puppies and/or cats/kittens and I/we assume such risks.*
Choose one: I Agree

This Permission and Release Form is binding upon me, my spouse, partner and my and his or her respective heirs, successors, assigns, executors and personal representatives.*
Choose one: I Agree

In case of emergency, I authorize the Wags and Whiskers Pet Rescue to arrange emergency medical treatment after attempting to notify the contacts listed below. List 2 personal contacts below

Emergency Contact 1 Name*

Please provide any relevant information regarding medical insurance for the applicant, including Insurer Name, Policy Number, Phone number, Physician Name, and Phone number. Wags and Whiskers cannot provide insurance coverage for volunteers. If you were to get bit or scratched you would be financially responsible for any medical expenses. *

Applicant E-signature. *

Parent/Guardian E-signature