EmailMe Form - Volunteer Application

Name *

First Last

Date

Mailing Address

Cell Phone

### - ### - ####

Alternate Phone

### - ### - ####

Email *

Age

19-22

23-30

31-50

over 50

Are you currently a student?

Not a student

High School

Junior/Tech college

College/University

Place of Employment

Are you applying to volunteer because you must complete court-ordered community service?

NO

YES

If yes, service hours needed

What experience do you have working with animals?

What times and days are you available for volunteering at HSWA?

If you are volunteering for cat and/or dog care, please see volunteer opportunities list for times that we are at the adoption facilities.

In what areas would you like to volunteer?

Emergency Contact Information

Contact Name

Contact Phone

### - ### - ####

Relationship

Release Agreement

1. I am 19 years of age or older.
2. I will abide by the mission, rules, regulations, policies, and procedures of The Humane Society of West Alabama (HSWA) while I am a volunteer.
3. I understand and assume the risks of being bitten, scratched, injured, or frightened by cats, kittens, dogs, and puppies in connection with my volunteer activities for HSWA, unless they are the result of HSWA's gross negligence or intentional misconduct. I will indemnify, defend, and hold harmless HSWA 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 HSWA or my breach of HSWA's rules, regulations, policies, and procedures.
4. I understand and agree that HSWA may reject volunteer applications for any reason.
5. I have accurately and truthfully completed this Volunteer Application. This agreement is binding upon HSWA, me and HSWA's and my respective heirs, successors, assigns, executors, and personal representatives.

Required *

Yes, I agree

By clicking this box I confirm that I have read, understand, and agree to the terms and conditions stated in the above Release Agreement.