Pet Volunteer Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastWhere did you hear about us? *Sex *MaleFemaleBirthdate *Local Address *Address Line 1CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Preferred Contact Method *CallTextEmailEmployer *Occupation *Have you done volunteer work before, and if so, what agency & please describe: *Please list prior experience with animals: *Why do you want to volunteer with us? *Do you have any physical / mental limitations? Please list: *Check all areas you are interested in utilizing your skills and time to help with: *Marketing animalsSocializing catsSocializing dogsWalking dogsCleaningManning EventsFundraising/ Grant writingOrganization / managing parts of the rescueVolunteer organizerGarnering in kind donationsNetworking with other rescuesEvent planningPhotographySocial mediaHelping build containmentsAvailability: Please list days/hours you are available, please list your availability in the lines provided below, also making note if you are available on weekends. * Emergency Contact Emergency Name *Emergency Phone *VOLUNTEER STATEMENT OF UNDERSTANDING, WAIVER & HOLD HARMLESS AGREEMENTI understand that there is an inherent risk associated with handling animals while volunteering for Crux Pet Adoptions. I release, discharge, indemnify and hold harmless Crux Pet Adoptions & Crux Rock Gym from any and all claims, causes of action or demands of any nature or cause connected with my volunteer services, including, but not limited to, any financial cost or obligation, attorney’s fees and court costs that may be incurred. Such risks may include but are not limited to: animal bites, accidents, injuries and personal property damage. I understand that bites or other wounds from animal handling can be very serious in nature. They may cause injury or infection which may require professional medical attention, medication and hospitalization. I agree to follow all Crux Pet Adoption protocol and procedures with respect to reporting and immediate treatment of animal bites or wounds I may sustain while volunteering at Crux Pet Adoptions, including seeking immediate professional medical assistance. Crux Pet adoptions recommends that any wound inflicted by an animal during your volunteer time at our clinic be immediately evaluated by a medical professional. I understand that treatment or costs associated with any illness or personal injury sustained while in my capacity as a Crux Pet Adoption volunteer, regardless of the nature or reason, shall be covered by me or my personal insurance. I understand that public relations/outreach is important for Crux Pet Adoptions and its mission. I, therefore, agree to allow Crux Pet Adoptions to use any photographs, video or film taken of me while volunteering. I understand that I will not be notified when Crux Pet Adoptions intends to use my image whether in photographic, video or film medium when used for public relation/outreach purposes. I understand that I may “opt-out” of having my image used in Crux Pet Adoptions promotion by providing written notice to Crux Pet Adoptions coordinator prior to my first volunteer shift. I understand that either Crux Pet Adoptions or I may terminate the Crux Pet Adoption/volunteer relationship at any time for any reason. I also understand that Crux Pet Adoptions relies on its volunteers to arrive punctually for their appointments and to give adequate notice to the Crux Pet Adoption coordinator when unable to meet a scheduled commitment or when needing to terminate the Crux Pet Adoption/volunteer relationship.Electronic Signature *Write your full name above if you have read and fully understand the terms and conditions of this volunteer agreement and are willingly comply with all of its conditions. Submit