First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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County

Country

Email*

Home Phone

Work Phone
x

Cell Phone

Text/Pager Email

How would you like to volunteer?*

Have you volunteered with other organizations? If so, who?*

How often would you be able to help?*

I understand that this Agreement is a contract between me and the Rescue and that this Agreement waives legal rights that I now or may have in the future and releases the Rescue from any and all claims for injury or damages sustained by me.
Choose all that apply: Yes No

I am voluntarily participating in the volunteer activities described below and fully understand the nature of the activities for which I am volunteering. I assume any and all risks associated with my participation in said activities, including but not limited to injury or illness. *
Choose one: Yes No

I understand that there are risks and dangers associated with working with wild, feral and domesticated animals, including but not limited to, bites, scratches, zoonotic diseases (diseases transmitted from animals to humans), and allergic reactions. *
Choose one: Yes No

I will not appear for volunteer service under the influence of alcohol or illegal drugs.*
Choose one: Yes No

I will not go beyond the scope of the agreed-upon volunteer activities without authorization from a Board Member or Rescue Representative who is authorized to grant such authorization. *
Choose one: Yes No

I agree to follow the Rescue’s Code of Conduct by: • Bringing my best skills and abilities to my volunteer work; • Exercising caution and common sense when dealing with rescue animals to assure the safety of all volunteers, the general public and rescue animals; • Treating all animals with kindness and respect; • Supporting the Rescue’s mission, goals and efforts; • Maintaining a positive attitude; • Approaching and performing my volunteer activities in a professional manner; • Promoting goodwill, courtesy and cooperation in my interactions with Rescue staff, volunteers, fosters, adopters, other members of the rescue community and the general public; • Remembering that, as a Rescue volunteer, I am advocating for the Rescue and its animals; • Correcting, when possible, misleading or inaccurate information or representations made by others concerning the Rescue’s policies, practices or procedures; • Maintaining the confidentiality of all written and oral information I may receive while volunteering for the Rescue. *
Choose one: Yes No

I fully and voluntarily assume all risks associated with the volunteer activities I am undertaking for the Rescue. I will use my best judgment in undertaking and performing these activities. I also agree to follow the rules and safety instructions as explained to me by Rescue representatives and volunteers authorized to engage in similar activities.*
Choose one: Yes No

I fully agree to follow the following transportation protocol. ADULTS: Night before transport a Dawn bath should be given if possible. All dogs should be double leashed: 1 slip lead, 1 collar and 1 leash. No food after 6pm the day before transport. Every 2 hours water should be offered. No food except for a cookie or 2 to be given at the exchange of transfer. At exchange dog(s)is to be walked and given bathroom break. Remember to clean up after dog(s). Offer dog a drink of water before load up. Overnight fosters are to provide a high quality meal within the first 2 hours of arrival. High protein diet is highly recommended during transport. Adults are required to have at least 8 hours of down time. Special need dog(s) should have 12 hours of down time.*
Choose one: Yes No

I agree that I will not sue, prosecute, or make any other claim against the Rescue for injury or damage to me or my property arising out of the adoption or any related activities performed on behalf of the Rescue and resulting from negligence or other acts, however caused, by any Rescue officer, volunteer, employee, agent, workman, contractor or other authorized representative.*
Choose one: Yes No

I fully and forever release and discharge the Rescue from any and all liability, causes of action, claims or demands that I have now or may have in the future, whether known or unknown for injury, illness, death or other damage arising out of or related in any way to the volunteer activities I am performing for the Rescue.*
Choose one: Yes No

Unless I specifically state otherwise, I consent to the Rescue using my name or image in photographs, video and/or sound recordings published on television, radio, the internet or in print in stories, news articles, advertisements, or other written or digital materials. I understand that such uses include, but are not limited to, promotion of adoptable dogs, education, advocacy, fundraising and any other purpose that furthers the Rescue’s mission. I understand that the Rescue will not provide me with advance notice of its intention to use my name or image in the manner set forth above and that I will receive no payment or other consideration for the use of my name or image. I understand that I can revoke the Rescue’s right to use my name or image in the manner described above by notifying the Rescue in writing of this revocation.*
Choose one: Yes No

I understand that the terms of this Agreement and these rights apply to and bind me, my heirs, successors, assigns, guardians or other legal representatives.*
Choose one: Yes No

I understand that this Agreement and Waiver of Liability protects and is for the benefit of the Rescue, its affiliates, and the officers, directors, consultants, volunteers and all others acting on behalf of the Rescue and its affiliates.*
Choose one: Yes No

TERMINATION: I understand that either the Rescue or I may terminate this Agreement at any time without cause, upon providing written notice of termination date. I understand that this is an at will relationship and that either party may terminate the Agreement at any time without prior notice or reason. Written notice of intent to terminate the Agreement should be delivered to the last known mailing address or email address of the Rescue or the Volunteer. E-mail address: fila911rescueandrehab@gmail.com Mailing Address: Fila 911 Rescue and Rehab c/o Dianne Kuykendall 102 Berry Rd Jasper, Alabama 35504 *
Choose one: Yes No

This contract is governed by the laws of the State of Alabama.*
Choose one: Yes No