First Name*

Last Name*

Address*

City*

State* select a state... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code*

Phone*

Age

Email*

Emergency Contact Name

Emergency Contact Phone

Are you volunteering for service hours?
Yes
No
Where?

Do you have any physical limitations or disabilities that might hinder you from participating in some activities?(heart condition, back injury, allergies, etc) If yes, please explain.

Do you have any experience with animals?

As a volunteer, I understand that:

• I MUST wear closed toed shoes, no flip flops or sandals
• No dangling jewelry or personal items
• Clothing worn may become dirty and/or damaged while volunteering
• I will not receive any compensation
• Volunteering at Cheyla's Rescue Foundation and with animals may lead to injury and illness and I assume all liability and risk associated with volunteering
• I must comply with all rules, agreements, and protocols that are established and may change from time to time by Cheyla's Rescue Foundation

Code of Conduct:

• Show up in a timely manner to scheduled volunteer time. Please call or text if you are going to be late or are unable to make it to your shift.
• Be dressed appropriately
• Always conduct myself in a professional manner when involved with Cheyla's Rescue Foundation, this includes keeping vehicles in regulation with posted speeds around Summit Bridge Veterinary Hospital
• Perform tasks under the guidelines I was taught
• Adhere to all established policies and procedures
• Report ANY abusive behavior in the Rescue to any Doctor or Rescue Coordinator

As a volunteer, I understand and agree that:

• I am providing my services in a volunteer capacity without any expectation of salary or benefits
• Using or being under the influence of alcohol or drugs is prohibited while volunteering
• If found being incompliant with any of the rules established, my volunteer involvement may be terminated

As a volunteer working with animals, I am expected to:

Treat the animals with respect and kindness

Report animal injuries, illness, or behavior concerns to a staff member

Never handle an animal that makes me feel afraid or uncomfortable

By signing this form, I/we acknowledge that all information on this form is true and correct.

Media Release:
I grant Cheyla's Rescue Foundation permission to use my name, likeness, and statements in photographs, audio, video, or other media, if any, to promote Cheyla's Rescue Foundation programs or events. I understand that all film, audio, and prints are the sole property of Cheyla's Rescue Foundation and may be used without payment or notification.

Signature*


Date

Parent Signature*


Date