"ACTIVE VOLUNTEER" is a person (family) who makes a commitment of volunteering 100 hours or more per year doing one or more of the following activities. To run for the Board of Directors and vote in an election for the Board, you must complete 100 hours of service between March 1st, and the last day of February annually. FOR PERSONS 15 AND OLDER: 1. Working a regularly scheduled shift at the shelter (4 hours credit per shift). I will be able to work the following day(s)__________________________________________________ 2. Working a regularly scheduled shift at PetSmart/other locations (5 hour credit per shift). I will be able to work on the following day(s)__________________________________________________ 3. Shelter maintenance is on Thursdays and Sundays weather permitting. Approximate time is 12 noon to 4 pm. (Hours worked + 1 hr.credit). I will be available to work on Thursday: Yes____No____ Sundays: Yes____No_____ 4. Fund raising, ongoing and special projects, etc. (hours worked). I am willing to participate in these functions:Yes____No____ 5. Please indicate your talents, hobbies, or special interests: Arts/Crafts__________________Carpentry_____________Computer Work_____________ Needlework/Sewing____________Writing____________Gardening_____________Painting__________ Pet Pal_______Other____________________Dog Walking_______((Children under the age of 15 must be accompanied by a parent/guardian/or licensed driver for the duration of the visit to the shelter). To be listed on the Active Volunteer Roster, the above commitments must equal 100 hours! I_______________________, realize that volunteering with the Animal Aid Society may expose me to some risks. I acknowledge that I will be working with dogs who, for the most part, are strays and that some of them may have been abused and may have the tendency to bite or harm me! With this in mind, I hereby freely volunteer to work and assist in taking care of and providing for the dogs and other animals housed by the Animal Aid Society. To enhance my safety and the safety of the animals, I hereby agree by the rules and policies of the Society and its duly elected Board of Directors. In addition for sufficient consideration, the receipt of which is hereby acknowledged, I hereby waive my right to proceed against the Animal Aid Society should I be harmed by any dogs and other housed animals or sustain any type of injury of whatever nature working with the Animal Aid Society. Executed this_________day of______________, 20___________ Printed Name:_______________________Signature:______________________ Address:________________________________City:___________________________ State:___________________________Zip:___________________ Work Phone#:________________Home Phone#:_______________Cell Phone#:___________ Witness:__________________________________________________ If you would like to be notified of shelter events by e-mail, please list your e-mail address:___________________________________________________ PLEASE INDICATE HOW YOU LEARNED OF THE ANIMAL AID SOCIETY:__________________________ PLEASE INDICATE IF THIS IS COMMUNITY SERVICE RELATED TO THE SCOUTS:________________________OTHER:________________________________________________ FOR PERSONS 15-17 YEARS OLD: I,__________________________parent of_____________________ do hereby give my permission for my child, age________, to volunteer with the Animal Aid Society and I hereby acknowledge my child's execution of this Waiver and Release, and as his/her parent agree to the terms and conditions of same. Parent's signature:_______________________________________ FOR ALL VOLUNTEERS: Date of last Tetanus shot:__________________(Good for 10 years) Do you have any health issues?_____________________________________________ High/low blood pressure:________High/low blood sugar:______Pregnant:__________History of seizures:___________Some health issues require a doctor's consent before volunteering at the shelter. April 2007 |