VOLUNTEER APPLICATION/WAIVER

PO Box 11445, Charleston, WV, United States, 25339

(304) 444 5970

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VOLUNTEER APPLICATION/WAIVER

First Name

Last Name

Date of birth

Address

City

State

Country

Postal code

Phone Number Work

Phone *

Cell phone:

Email *

Employer/Job Title:

May we contact for reference

Yes

No

N/A

If yes, please provide name and phone # of employer:

Allergies or physical restrictions

How did you hear about PICK OF THE LITTER Animal Rescue?

Why do you want to volunteer at Pick of The Litter Animal 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).

If you would like to comment more on your experience with the above, please do so here:

If you listed other, please explain:

Would you be willing to volunteer off the shelter premises?

Yes

No

Reference #1 (Name, phone # and relationship to self)

Reference #2 (Name, phone # and relationship to self)

Reference #3 (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 Pick Of The Litter Animal Rescue (POTLAR). WHEREAS, the Volunteer has voluntarily contacted POTLAR and has expressed an interest in working with dogs/cats in the care and custody of POTLAR. In consideration of POTLAR’s agreement to allow the volunteer to view and/or interact with such dogs/cats, 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/cats pose and have elected to view and/or interact with one or more dogs/cats in the care of POTLAR voluntarily. The volunteer knowingly assumes all risks that exposure to dogs/cats 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 PICK OF THE LITTER ANIMAL RESCUE, 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/cats.

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 The Pick of The Litter Animal Rescue.

Anything else you would like to say, please note it here:

PO Box 11445, Charleston, WV, United States, 25339

Email
pickofthelitter2020@gmail.com

About Pick Of The Litter

Pick Of The Litter Is a Volunteer Nonprofit dedicated to rescuing abandoned, & abused animals!

We specialize and focus on neonatal care, special needs, and seniors in need.

Contact Us

(304) 444 5970

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