Application To Volunteer - Max's Ark Rescue

First and Last Name *

Date of Birth / AGE *

Street Address *

City *

State

Zip *

Home Phone

Cell Phone

Work Phone

Email Address *

Employer

Job Title:

May We Contact for Reference?

If Yes, Name and Phone Number of Employer

Allergies or Physical Restrictions?

How did you hear about Max's Ark Rescue?

Why do you want to volunteer with Max's Ark Rescue?

Do You Work Any Other Rescue Organizations? *

If so, Please enter their name and contact number.

Please list any pets you currently own (or have owned in the past):

If you listed 'other', please explain:

If you would like to comment on your experience above, do so here:

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

If you Listed 'Other' please explain:

When Are You Available To Volunteer

Check all that Applies

Weekdays

Weekends

Reference #1 *

Please Provide Name and Contact Number

Reference #2 *

Please Provide Name and Contact Number

Reference #3 *

Please Provide Name and Contact Number

Any Additional Comments?

In Case of Emergency, who do we contact?

Please provide name and Phone Number

This volunteer agreement (“Agreement”) is entered into as of the date set forth below by Max's Ark Rescue. INC,. WHEREAS, the Volunteer has voluntarily contacted Max's Ark Rescue (MAR) and has expressed an interest in working with dogs in the care and custody of Max's Ark Rescue. In consideration of MAR’s agreement to allow the volunteer to view and/or interact with such dogs, 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 MAR voluntarily. The volunteer knowingly assumes all risks that exposure to dogs 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 MAR, 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 Entering Your Name Here, you are agreeing to the above liability waiver. *

By Entering Your Name Here, you are stating that you are the parent/guardian of the above applicant.

You are granting permission for them to volunteer with Max's Ark Rescue, INC. (Required if applicant is under 18)