Volunteer Application

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First Name *

Last Name *

Phone Number *

Email Address *

Emergency Contact Name *

Emergency Contact Phone Number *

Animal Experience or Training *

Volunteer Experience *

How did you learn about this volunteer opportunity? *

Please check the activities you are interested in *

Dog Walking

Cat Cuddling

Dog Yard Time

Washing Dishes

Laundry Folding

Landscaping/Mowing/Weeding

Project/Group Volunteering

Event Fund Raising

Help Clean Kennels & Cat Rooms (in the am)

Required

Do you have any limitations? *

Do you have any serious allergies? *

Have you ever been convicted or adjudicated for any kind of animal abuse or neglect? *

Have you ever been convicted or adjudicated for any violent crimes against a person?

I hereby affirm this information is true and BMHA has permission to use said information to verify my background.

In consideration of this opportunity to volunteer, I agree to the following terms and conditions: I will sign-in and check-in with staff upon arrival and throughout my time while volunteering. I will always follow their directions. I will stay within areas designated for volunteers and will not enter the stray dog kennels nor the isolation room. I will notify the staff should any concerns or safety issues be observed. I will ask the staff questions if I am unsure about a task. I will conduct myself with professionalism and respect. I will always keep safety in mind when working with the animals, other volunteers, staff, or members of the public while performing my duties as a volunteer for BMHA. Blue Mountain Humane Association reserves the right to decline any applicant.

By digitally signing first and last name you fully realize that you will be participating in a volunteer capacity at the Blue Mountain Humane Association, an animal shelter, and doing so of your own free will and initiative and at your own risk and responsibility. You understand that animals may be unpredictable and assume the risk of being scratched, bitten, or injured or frightened by cats or dogs in connection with this volunteer work with BMHA. You acknowledge that you understand and accept the inherent risks associated in this capacity. To the fullest extent permitted by law, you hereby release, waive, discharge, and hold harmless Blue Mountain Humane Association, its officers, directors, employees, agents, and affiliates from any and all claims, demands, causes of action, liabilities, and expenses, including legal fees, arising out of or in any way connected to your volunteer activities. You agree to indemnify, defend, and hold harmless Blue Mountain Humane Association, its officers, directors, employees, agents, and affiliates from and against any and all claims, liabilities, damages, losses, and expenses arising out of or in connection with your volunteer activities.

By signing your name below you are agreeing to the above statement

Full Name *

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This form was created inside of Blue Mountain Humane Association.