ADULT VOLUNTEER FORM

I WISH TO BE A VOLUNTEER AT THE
NEW ROCHELLE HUMANE SOCIETY

NAME:

ADDRESS:

CITY:  STATE:  

ZIP:   E-MAIL

PHONE: Daytime:
                 Evening:

I WOULD BE INTERESTED IN: 

           Walking and brushing dogs                    
             
              Playing with and brushing cats

              Training dogs

              Quiet time with dogs

              Fund raising

              Publicity

              Computer entries

              Clerical work

              Outreach (visits to nursing homes, hospitals, schools)

              Community events

              Adoption days

              Other_______________________________________________

              Do you have any experience with dogs and/or cats?  If so, please tell us what it is.

               __________________________________________________________

              __________________________________________________________ 

              Do you have any work experience, which would help with any of the above? 
              (i.e. computer work, teacher, fundraiser etc.)

              ________________________________________________________

              __________________________________________________________

              When could you volunteer? (what day or days, number of hours)                         
             
              __________________________________________________________   

  Mail Form to :
The New Rochelle Humane Society
70 Portman Road
New Rochelle, NY  10801
(914) 632-2925

ADULT VOLUNTEER AGREEMENT

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

               I.     I will abide by the mission, rules, regulations, policies and programs of the Humane Society while I am a volunteer.

                   II.     I assume the risks of being bitten, scratched, injured or frightened by cat, kittens, dogs and puppies in connection with my volunteer work for the Humane Society.  The Humane Society 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 Humane Society, unless they are the result of the Humane Society’s gross negligence or intentional misconduct.  I will assure, defend and hold the Humane Society harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever sustained by any companion animal or any person in connection with my intentional misconduct or grossly negligent performance of volunteer activities for the Humane Society or my breach of the Humane Society’s rules, regulations, policies and programs. 

                III.     I understand and agree that the Humane Society may refuse volunteer applications for any reason.

                 IV.     If I will be sheltering or providing foster care or boarding any of the Humane Society’s animals in my home or business, I consent to the Humane Society visiting my home or business from time to time to observe the animals and their living quarters.

                   V.     I have accurately and truthfully completed this volunteer application and agreement.

                 VI.     Any modification to this agreement must be in writing signed by both parties.  This agreement is binding upon the Humane Society, me and the Humane Society’s respective heirs, successors, assigns, executors and personal representatives.

APPLICANT:                                                              HUMANE SOCIETY:

_____________________________________________________________________________________

Sign Name                                                                Sign Name (Manager)

_____________________________________________________________________________________

Print Name                                                                Print Name (Manager)

Date___________________________                        Date __________________

The New Rochelle Humane Society
70 Portman Road
New Rochelle, NY 10801