Volunteer Application

First Name

Last Name

Age

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Home phone

Work Phone

Cell Phone

Employer/Job Title

May we contact for reference?

Yes

N/A

If yes, please provide name and phone number of employer

Allergies or physical restriction

How did you hear about Stand Up Pups

What ideal volunteering do you want to do at Stand Up Pups?

Do you work with any other rescue organizations, if you which ones?

Yes

Else

If else:

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:

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

If you listed other, please explain:

When are you available to volunteer? (check all that apply)

Weekdays

Weekends

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

Reference #2 (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 Stand Up Pups. WHEREAS, the Volunteer has voluntarily contacted SUP and has

expressed an interest in working with dogs in the care and custody of SUP. In

consideration of SUP'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 SUP 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 TLR, 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 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 Last Resort Rescue.

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

Volunteer Application

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