Volunteer Application

Name *

First

Last

Email *

Birthdate *

MM/DD/YYYY

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone *

Please choose your area(s) of interest: *

You must be at least 21 years of age to volunteer at The Animal Haven, Inc.

Please be advised that if you have any allergies to cats or dogs or their dander, you may not be comfortable working in the shelter or with the animals.

Why do you want to volunteer at The Animal Haven, Inc.? *

For how long do you intend to volunteer at The Animal Haven, Inc.? *

What days and times are you available to volunteer at The Animal Haven, Inc.? *

Please provide any additional skills that you have that might assist us in finding a volunteer position for you: *

Please provide a contact person in case of an emergency:

Emergency Contact Name *

Relationship to you

Home/Cell *

Your Signature (I agree to sign this application electronically) (use mouse to sign) *

Date *

Volunteer Agreement *

I intend to donate services to The Animal Haven, Inc. (the "The Animal Haven") as a volunteer. As a volunteer, I understand that I will not be compensated for any time spent volunteering at The Animal Haven and that I am not entitled to any benefits, including employment insurance benefits upon the termination of this agreement or as a result of this service.

I am aware that participation as a volunteer at The Animal Haven will require the exercise of reasonable care to avoid injury. I am volunteering at The Animal Haven with knowledge of the hazards and potential dangers involved, and I ASSUME ALL RESPONSIBILITY AND RISK WITH RESPECT TO ANY DAMAGES, INCLUDING ANY PERSONAL INJURIES AND/OR PROPERTY DAMAGE, RESULTING FROM MY BEING A VOLUNTEER AT THE ANIMAL HAVEN. As consideration for the opportunity to volunteer at The Animal Haven, I hereby agree that I, and my assignees, heirs, guardians, and legal representatives, will not make a claim against or sue The Animal Haven or its officers, directors, employees, agents, volunteers and/or contractors for any damages, including personal injuries or property damage, resulting from the negligence, whether active or passive, or other acts, however caused, by The Animal Haven, its officers, directors, employees, agents, volunteers and/or contractors. I HEREBY WAIVE ANY SUCH CLAIMS AND RELEASE AND DISCHARGE THE ANIMAL HAVEN AND ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, VOLUNTEERS AND/OR CONTRACTORS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, AND/OR LEGAL REPRESENTATIVES NOW HAVE, OR MAY HAVE IN THE FUTURE, FOR ANY PERSONAL INJURIES, PROPERTY DAMAGE AND/OR OTHER DAMAGES RESULTING FROM MY VOLUNTEERING AT THE ANIMAL HAVEN, INCLUDING ANY DAMAGES DUE OR CLAIMED TO BE DUE TO ANY NEGLIGENCE OF THE ANIMAL HAVEN, ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, VOLUNTEERS AND/OR CONTRACTORS.

I UNDERSTAND THAT IF I AM INJURED IN THE COURSE OF WORK AS A VOLUNTEER AT THE ANIMAL HAVEN, I AM NOT COVERED BY THE ANIMAL HAVEN'S WORKERS' COMPENSATION PROGRAM. I authorize The Animal Haven to seek emergency medical treatment on my behalf in case of injury, accident or illness to me arising from my involvement as a volunteer. I understand that I will be responsible for the medical costs incurred as a result of such accident, illness or injury.

PROTOCOLS WITH RESPECT TO THE DOG KENNEL AREA *

I agree not to give treats of any kind to the dogs in the kennel unless specifically provided by a staff member of The Animal Haven ("an Animal Haven staff member"). I also agree not to give the dogs in the kennel any toys, stuffed animals or blankets of any kind without the permission of an Animal Haven staff member. I understand that too many treats can cause stomach upset, i.e., diarrhea, and that dogs by nature tend to chew on leashes, toys, and blankets and can become "blocked," which means they can become seriously ill and need surgery. I also agree not to touch any of the dogs in the kennel or otherwise handle them without the permission of an Animal Haven staff member and to handle the dogs only in accordance with the directions of an Animal Haven staff member. Because the staff cannot always be in the kennel or otherwise with the dogs when there are visitors at the shelter, I agree to report to an Animal Haven staff member anything that I see or hear that is contrary to these protocols or otherwise out of the ordinary.

PROTOCOLS WITH RESPECT TO THE CAT ROOMS *

I agree not to pick up, remove from their cages or otherwise touch any of the cats in the shelter without the permission from an Animal Haven staff member. Additionally, I understand that many of The Animal Haven's cats suffer from time to time with chronic conditions such as upper respiratory infections and other bacterial or viral infections, which can include sneezing, ocular discharge and/or general lethargy. I have been informed that hand washing or disinfecting is the most important protocol to limit the spread of these infections, and that, therefore, it is imperative that I wash and/or disinfect my hands after I touch one cat and before I touch another cat. If I touch one cat and then touch another cat without disinfecting my hands, I will expose the second cat to any infection that the first cat may have had. I also understand that I must disinfect my hands when I move from one cat room to another at the shelter because infections also easily can be spread when I touch doorknobs and other surfaces when leaving one room and entering another. I have been informed that The Animal Haven also from time to time has cats with "ring worm" that are symptomatic. Ring worm is not a worm. Rather, it is a skin condition that manifests itself during stress producing crusty areas and hair loss. Since ringworm is a condition passed back and forth from humans to cats, I understand that it is imperative that I disinfect my hands after contact with any cat. I agree to report to an Animal Haven staff member anything that I see in the cat rooms that is contrary to the protocols set forth above.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS AGREEMENT CONTAINS A WAIVER, ASSUMPTION OF RISK AND RELEASE OF LIABILITY, AND I SIGN THIS AGREEMENT, THE ASSUMPTION OF RISK AND RELEASE OF LIABILITY OF MY OWN FREE WILL.

Your Signature (I agree to sign this agreement, waiver and release electronically) (use mouse to sign) *

Date *

You must be at least 21 years of age to volunteer at The Animal Haven, Inc.

Please be advised that if you have any allergies to cats or dogs or their dander, you may not be comfortable working in the shelter or with the animals.

Please provide a contact person in case of an emergency:

Thank you for your interest in The Animal Haven, Inc. and for your participation in our volunteer program.

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