First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone*
What is your age?* Choose one: Under 18 18-24 years old 25-34 years old 35-44 years old 45-54 years old 55-64 years old 65-74 years old 75 years or older
Employer / Job Title:*
May we contact for reference?* Choose one: Yes No NA
Please provide name and phone # of employer: If N/A, please explain.*
Allergies or physical restrictions: *
How did you hear about TLC K9 Rescue? *
Why do you want to volunteer at TLC K9 Rescue? *
Do you work with any other rescue organizations?* Choose one: Yes No
If so, please give contact information for that organization including name and phone#:
Please list any pets you currently own including age, breed, and temperament(s). *
Animal Experience: (check all that apply)
If you would like to comment more on your experience with the above, please do so here.
If you listed other, please explain:
Volunteer Work Preferences: (check all that apply)
To Foster, please fill out the Foster application on our website.
When are you available to volunteer? (check all that apply)
Reference #1 (Name, phone# and relationship to self) *
Reference #2 (Name, phone# and relationship to self) *
Reference #3 (Name, phone# and relationship to self) *
Any additional comments:
In case of emergency, who should we contact? (name and phone#)*
This volunteer agreement ("Agreement") is entered into as of the date set forth below by TLC K9 Rescue. WHEREAS, the Volunteer has voluntarily contacted TLC K9 Rescue and has expressed an interest in working with dogs in the care and custody of TLC K9 Rescue. In consideration of TLC K9 Rescue's agreement to allow the volunteer to view and/or interact with such dogs, the volunteer hereby, for his/ her heirs, his/her personal representatives, and him/herself represent and warrant as follows:
1. The volunteer is fully aware of the risks that dogs pose and have elected to view and/or interact with one or more dogs in the care of TLC K9 Rescue voluntarily. The volunteer knowingly assumes all risks that exposure to dogs may pose, including but not limited to serious bodily injury and/or death.
2. THE VOLUNTEER HEREBY WAIVES, RELEASES DISCHARGES, HOLD HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINT TLC K9 Rescue, its directors, officers, volunteers, staff, and all other agents, and attorney for any of the referenced parties and any other parties acting for or on behalf of the referenced partied from an and all rights and claims which the volunteer has or which may hereafter accrue to the volunteer and from any and all damages which may be sustained by the volunteer directly or indirectly in connection with, or arising out of, the volunteer's exposure to such dogs.
By writing your name here, you are agreeing to the above liability waiver.
By writing your name here, you are agreeing to the above liability waiver. *
Legal parent(s) or legal guardian(s) signature.
By writing your name here, you are stating that you are the parent/guardian of the above applicant and you grant your permission for them to volunteer with TLC K9 Rescue and agree to the above liability waiver. If not applicable, type N/A*
TLC K9 Rescue clients, if required and upon completion of successor dog application, do you agree to a background check along with any household residents 18 and older?* Choose one: Yes No
I declare or certify under penalty of perjury under the laws of the State of California, that the foregoing is true and correct.* Choose one: I agree and understand
