Center Valley Animal Rescue · Volunteer Interest Form

Contact Information

Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Primary Phone Number

*

Email

*

Verify Email

*

Emergency Contact Information

Emergency Contact Name

*

First Name

Last Name

Emergency Phone Number

*

Emergency Email

*

Verify Email

*

Relationship to Emergency Contact

*

(Parent, guardian, spouse, etc.)

Scheduling

Availability

When can you volunteer?

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Approximately how many hours can you volunteer per week?

It helps us if you can keep a consistent and regular schedule. If you don't anticipate being able to come every week, that is ok too. Just let us know.

Volunteer Questions

Birth Date

*

(mm/dd/yyyy)

Are you 18 or older?

*

Youth ages 8-17 are welcome to volunteer at CVAR. Those under 18 must be accompanied by a parent or guardian.

Yes

No

If under 18, do you have an adult that can accompany you while volunteering?

*

Yes

No

How did you learn about volunteering at CVAR?

*

CVAR Website

Volunteer Match

Social media

Word of mouth

Event

Educational Institution

Other

If other, please describe.

Why are you interested in volunteering at CVAR?

*

Tell us about yourself!

We would love to learn more about you! Please tell us about your interests, background, education, and/or special skills.

Do you have any specific species that you are interested in volunteering with? (ok if you don't yet know)

Cats

Dogs

Birds

Quarantine/Isolation

Farm (horses, goats, pigs, etc.)

Rabbits

Reptiles

Other

Accessibility

What do you need in order to be successful as a volunteer at CVAR? Please let us know of any accessibility needs or concerns that you have.

Allergies

Medical conditions

Physician Name

Physician Phone

Do you have any previous volunteer/work experience with animals?

Briefly describe

Do you currently live with any animals?

*

Yes

No

If yes, please list number and species:

Are they spayed/neutered?

Yes

No

Are they up to date on all vaccinations?

Yes

No

Are you or have you been affiliated with any animal organizations in the past? If so, which ones?

Waiver of Liability

I acknowledge that I am fully aware of the nature and extent of the potential hazards of volunteering at an animal rescue sanctuary and that I fully assume the risk of participation in any and all activities at Center Valley Animal Rescue, at the sanctuary residence or any and all locations where Center Valley Animal Rescue activities take place. I hereby acknowledge that I will release Center Valley Animal Rescue, its officers, directors, advisors, volunteers, property owners and/or agents in any location where Center Valley Animal Rescue activities are conducted, of and from all claims which may hereafter develop or accrue to myself on account of injury, loss or damage which may be suffered by said volunteer or to any property, because of any matter, thing or condition, negligence or default whatsoever, and I hereby assume and accept the full risk and danger of any hurt, injury or damage which may occur through or by any reason of any matter, think or condition, negligence or default, of any person whatsoever.

It is further agreed that I shall be fully responsible for any and all medical attention and treatment and all related costs in the event of an injury to myself as a result of my participation in any and all activities at Center Valley Animal Rescue aforesaid.

The invalidity of any statement or waiver of rights above under local, state or federal law does not invalidate any other statement or waiver of rights above.

I agree to the above conditions.

*

Yes