Volunteer Application


Full Name:	Date:

Address:

City:	State: Zip:

Home Phone:	Work Phone:

Cell Phone:	Email address:

Spouse's Name:	Employer's Name:

Profession:	Does your employer have a matching gift program? Yes No

What pets do you own?:

Emergency Contact:	Emergency Contact Phone No.:

Why are you interested in becoming a Fayette Humane Society volunteer?

Do you have court-appointed Community Service hours to complete? Yes No	If yes, how many?:

What is the reason for Community Service?

What other humane societies have you volunteered with?

Checking this box and typing my name in the space below (digital signature) indicates that I have read and completed this application fully and to the best of my knowledge and that all information I have provided is truthful and accurate.

Signature: Date:

Fayette Humane Society Volunteer Agreement

In consideration of this opportunity to volunteer, I agree to the following terms and conditions, intending to be legally bound by them:

1. I will abide by the rules and policies of the Fayette Humane Society ("FHS").

2. If I stop being a volunteer for the FHS for any reasons, or upon the FHS's request at any time, I will promptly return all of the FHS's supplies, equipment, records, monies, and other items in good, clean condition.

3. I assume the risk of bitten, scratched, injured, or frightened by kittens, cats, puppies, and dogs in connection with my volunteer work for the FHS. The FHS is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever which I might suffer or sustain in connection with the performance of my volunteer activities for the FHS.

4. I will indemnify, defend and hold the FHS harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by misconduct or grossly negligent performance of volunteer activities for the FHS, or my breach of the FHS's rules and policies.

5. I am at least 18 years of age and will show an ID with my name, address, age and photo.

                                                                       Name:

                                                                         Age:

                                                                        Date:

If the Volunteer is under the age of 18, his/her parent or guardian will be required to digitally sign this Release on the Volunteer's behalf. By digitally signing this Release, both parent/guardian and the Volunteer agree to the terms and conditions of this Release.

Parent/Guardian Digital Signature:

Parent/Guardian of Age:

Date: