It Takes A Village Non-profit Rescue

Full Name*

First Name Last Name

E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number

Do you have any physical or medical limitations that would limit the type of volunteer activities you can do?: (i.e. back problems, pregnancy, allergies )

Yes No

If yes, please explain

18 is the minimum age for volunteers to be at the shelter alone. For volunteers who are 16-17, a parent or legal guardian must sign a liability waiver at the shelter. Volunteers who are 15 & under must be accompanied by a parent or legal guardian at all times while at the shelter.

Yes I an 18 yrs or older

If under 18, please enter your age here

Emergency Contact

Full Name

First Name Last Name

Phone Number

- Area Code Phone Number

Relationship

Areas of Interest/Skills

Please indicate the areas of interest and skills you may have. Check all that apply.

Animal Care

Dog Walking/Socialization Dog Grooming Dog Feeding Kennel Cleaning

Events

Adoption Events Fundraisers

Thrifty Tails Thrift Shop

Sort, Prepare, Price and Display Merchandise Customer Assistance; Process Sales

Describe any special skills you may possess that are not listed above:

Availability

How often will you be able to volunteer?

Anytime Week Day Week Nights Weekends

Additional comments on schedule or anything else you would like us to know

VOLUNTEER AGREEMENT AND RELEASE

I hereby agree that I am providing volunteer services to It Takes a Village Canine Rescue, Inc. (ITV Rescue) and I understand that ITV Rescue is not responsible for any illness or injury caused by any animals that I come into contact with during my volunteer work.

I release and forever discharge It Takes a Village Canine Rescue, Inc., A & A Investments of Evansville & Ric Jo Inc. D/B/A Stockwell Inn., its board, volunteers, foster homes and representatives and veterinarians treating animals at the request of It Takes a Village Canine Rescue, Inc., from any and all claims and actions, including, but not limited to property damage caused by the animal, personal injury to me, family members, third parties or other animals from biting, scratching, transmittal of disease, and/or any other matter attributable to said animal. I understand that any animal has the potential to bite or cause injury. I further agree to indemnify and hold harmless the above-referenced, joint and severally, from any and all actions, claims, and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained during my volunteer work.

I acknowledge that ITV Rescue is an Indiana non-profit organization and any disputes or disagreements arising from my dealings with ITV Rescue are subjected to Indiana law and I consent to the exclusive jurisdiction of Indiana law.

Please Sign

First Name Last Name

It Takes A Village Non-profit Rescue

Volunteer

Application