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Volunteer application and release of liablilty  waiver

Volunteer Application

 

Thank you for your interest in volunteering!  Please complete the following application and send or deliver to one of the following addresses.  We cannot accept applications via email due to privacy policy protection.

 

By mail:

                                                                       

ATTN: Volunteer Coordinator

                                                                       

                                                                       

 

By Fax:

ATTN: Volunteer Coordinator

                                                                       

 

Once you submit the completed application, your forms will be processed and you will be contacted by the Volunteer Coordinator.  Please note that a phone or in-person interview with one or more of our staff members may be required.

 

If you have any questions regarding the status of your application, please contact the Volunteer Coordinator at email thebarnyardfoundation@gmail.com

 

NOTE: the minimum age for Volunteer applicant is 14.  We cannot make any exceptions.  All applicants under the age of 18 years, must have parental consent.  All persons applying to serve as a volunteer at The Barnyard Foundation must fully complete and submit the Volunteer Application.  No partial applications will be accepted.

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant

 

Thank you for applying volunteer for The Barnyard Foundation. We have several areas that you can serve as a volunteer.  They are equally exciting and play a great role in helping children, families, and the community directly and indirectly.  Volunteer areas include:

 

Events Only – Typically Friday through Sundays – Traveling to special events or on-site event help.
Caring for the rescue Animals at a private facility (Brushing/washing, animal care, etc)
Caring for the facility- Cleaning up after the animals, Handy man services, etc.
Marketing/Communications                                                       
Community Relations/PR   
Development/Graphic Design
Email/Phone customer services                                                  
Accounting                        
Other:   You tell us what skills you can provide

 

General Information: (Please Print)                                                        Date:                                        

 

Name:                                                                                                                                                  

                             First Name                                                               Middle Name                                          Last Name

 

Address:                                                                                                                                              

                             Street                                                                                                              City                                                      State               Zip Code

 

Date of Birth:                /                 /               Email:                                                                              

                                        MM                     DD                   YYYY

 

Occupation:                                                                                                                                          

Major Duties:                                                                                                                                        

                                                                                                                                                           

                                                                                                                                                           

Home Phone: (________)                                    Work Phone: (_______)                                           

Cell Phone:      (________)                                                 Fax #:             (________)                                       

 

Emergency Contact Information:

 

Name:                                                                                        Relationship:                                       

 

Emergency Contact Phone #: (________)                                                    

 

 

How did you hear about                                                                        ?

                                                                                                                                                           

                                                                                                                                                           

 

Preferences:

 

What days/hours per week are you available to volunteer?  Please list:

                                                                                                                                                           

                                                                                                                                                           

 

There are many opportunities to volunteer at __________________________________.  Please identify the area(s) of service you are interested in assisting.  Only select those that you are interested in and rate those appropriately. (Rate 1 – Most Interested, 2 – Interested, and 3 – Willing, If Needed).  You can pick more than 3 items.

 

General Support

 

             Make phone calls to gather information, inform organizations of upcoming events, etc.

             Make thank you calls or reply voice mails to donors

             Write thank you notes to donors

             Return emails and answer questions by using our standard email instructions

             Graphic design for printed materials or website (Experience is required)

             Information Technology supporting (Experience is required)

             Write News Releases for Media Outlets

             General research for managers

             Mailing or packing services

             On-line sale services

             In-house Inventory control

             Data entry by using Excel file, Word or database programs (Basic computer skills are required)

             Other support, please list in here:                                                                                              

 

Event Support

 

             Pick up and ship supplies for upcoming events

             Assist in Event planning and coordination

             Merchandise sales

             Inventory control

             Donation collection

             Check In

             Food or drink services (Kraft Services)

             Volunteer Orientations

             Event preparation – follow the instructions from Event Coordinator

             Other support, please list in here:                                                                                              

 

Animal Care at Private Facility. ( Caring for Rescues, Retired, Rehomed and Rehabilitated)

            Animal Care

             Facility, lights, utility, cleaning, handyman services, etc.

             Light Engineer

             Organizing Trucks and Trailers for events.

             Other support, please list in here:                                                                                              

 

 

 

What specific talents/assets would you like to bring to                                                                

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

What do you expect to gain from your volunteer experience? :

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

If you are a student:

 

School:                                                                        Field of Study:                                                   

Phone # (             )                                                      

Name of Parent/Guardian:                                                                                                                     

Parent/Guardian Phone #: (                )                                                               

 

Criminal Record:

Have you ever been convicted of a felony?  Yes_____________  No __________________

If Yes, please explain:

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

 

Please complete this form by reading and signing the following two pages, including:

Non-Disclosure Agreement

Background Investigation Consent Form

 

If you are under 18 years of age, please fill out the Parental Consent Form.

 

Two reference letters when requested.

 

 

                                                                                                                                                           

 

 

 

 

Non-Disclosure Agreement

 

NOTE:  Group Applicants must submit a signed copy of the Non-Disclosure Agreement for each person in the group.

 

As a volunteer, I hold in high esteem the right of  The Barnyard Foundation, its clients, volunteers  and employees to the Protection of Privacy.  By signing this document, I am agreeing to keep all information about the clients and employees of The Barnyard Foundation and agree to:

 

During the course of the relationship between _________________________________(Signatory) and  The Barnyard Foundation (The Company), each party may disclose to the other, or either party may otherwise receive through its connection with the other, Confidential Information, either directly by verbal, written or electronic communications, or indirectly by permitting employees or associates or agents of the party to observe various operations, processes, strategies or methods conducted or used by the other party.  Disclosures made by a party (the “Disclosing Party”) will be made upon the basis of the confidential relationship between Signatory and The Company and upon each party’s agreement that, unless specifically authorized in writing by the other party, the party receiving the Confidential Information (the “Receiving Party”) will:

Not be used for any other purpose other than the evaluation, or continuation of, a business relationship between The Company and Signatory;

 

Not disclose any portion of any Confidential Information to any person except those employees or representatives of the Receiving Party with a need to know such Confidential Information for purposes of the business relationship with the Disclosing Party;

 

Advise each such employee or representative before he or she receives direct or indirect access to such Confidential Information of the obligations of the Receiving Party under this Agreement, and ensure that each such person to whom Confidential Information is thus disclosed is aware of this confidentiality agreement which extends the Receiving Party’s obligations hereunder to such person;

 

Take strict precautions, at a minimum those as the Receiving Party affords its own confidential information of a similar nature, to safeguard and protect from direct or indirect disclosure to any other person or entity all Confidential Information disclosed by the Disclosing Party to, or otherwise received by, the Receiving Party; and

 

Upon the request of the Disclosing Party, immediately return to the Disclosing Party, or destroy, all tangible materials concerning Confidential Information, including but not limited to memoranda, notes, reports, agreements documents, drawings, hardware, disks and tapes, as well as copies or extracts thereof, whether such material was made or compiled by the Receiving Party or furnished by the Disclosing Party.

 

I have read and understand the Confidentiality Agreement as presented above to adhere to the guidelines set forth.  Additionally, I am aware that certain information pertaining to internal matters of the agency should be maintained confidential.  Sharing about agency policies, newsworthy issues, and other sensitive information should be done with concern for the welfare of the agency.

 

 

 

                                                                                                                                                                                                               

Signature                                                                                                                Date

 

 

 

                                                                                                             

Printed Name

 

 

 

 

 

 

Background Investigation Consent Form

 

NOTE:  This form must be completed by all applicants prior to engagement at ________________________________.

 

I, ________________________________________, hereby authorize The Barnyard Foundation  and/or its agents, to make independent investigation of my background, references, character, credit history, criminal or police records, including those maintained by both public and private organizations and all public records to include sexual offender and abuse registry for the purpose of confirming the information contained on my Application and/or obtaining other information which may be material to my qualifications for serving as a volunteer/intern now and, if applicable, during the tenure of my service with  The Barnyard Foundation I understand that should there be any such activity The Barnyard Foundation has the right to deny my application.

 

I understand that my driving record will also be obtained as a part of this inquiry.

 

I, hereby, release all individuals, companies, corporations, and agencies, public or private, connected therewith from any and all liability associated with the dissemination of such information pertaining to me.  I understand that I may request a complete and accurate disclosure of the information obtained.

 

                                                                                                                                                            

Applicant’s Signature                                                                                              Date

 

 

 

Printed name as it appears on your Driver’s License:                                                                                

Maiden Name (If Applicable)                                                                                                                 

Social Security Number                   -               -             

Date of Birth                -                 -              

Driver’s License #                                                                        Issued State                                         

 

Current Address                                                                                                                                   

City                                                                               State                            Zip                              

County                                                                                     

 

List the Addresses, Cities and States in which you have resided for the previous 10 years:

 

Address:                                                        City:                                State:               Zip:                 

Address:                                                          City:                                State:               Zip:                 

Address:                                                        City:                                State:               Zip:                 

 

 

 

Parental Consent Form

 

NO ONE UNDER 18 YEARS OF AGE WILL BE PERMITTED TO VOLUNTEER AT The Barnyard Foundation WITHOUT THIS COMPLETED FORM.

 

NOTE:  No one under 14 is permitted to volunteer at The Barnyard Foundation.

 

PARENTAL CONSENT AND ACKNOWLEDGEMENT FORM

We are delighted that your child is interested in volunteering at The Barnyard Foundation.  It is of utmost concern that your child has a rewarding and positive experience while volunteering at The Barnyard Foundation.

 

I agree that this document certifies that I am the parent or guardian of _________________________________ _______________________________ and hereby grant permission to The Barnyard Foundation

Adult volunteers or employees to obtain medical care from any licensed physician, hospital or medical clinic for the above named at such times deemed necessary for physical health purposes.

 

I hereby waive all claims against and agree not to sue The Barnyard Foundation, its officers, agents, employees and volunteers as a result of my child’s participation in this volunteer activity or any claim arising from injury of the child in the execution of the above actions.

 

 

                                                                                               

Participant’s Name (Please Print)

 

 

                                                                                               

Parent or Guardian Name (Please Print)

 

 

                                                                                                                                                           

Parent or Guardian Signature                                                                  Date

                                                    

 

 

 

 

 

 

VOLUNTEER WAIVER & RELEASE FORM

 

VOLUNTEER’S NAME (PLEASE PRINT)

 

First Name:                                                                      Last Name:                                                     

 

The Barnyard Foundation (the “Foundation”) is committed to conducting its programs, services, and activities (collectively, the “Compassion”) in a safe manner and holds the safety of Foundation volunteers in high regard.  However, volunteers and parents/guardians of minor volunteers must recognize that there is an inherent risk of injury when choosing to volunteer in performing and/or otherwise assisting the Foundation in providing Compassion (“Volunteer Activities”).

 

You are solely responsible for determining if you or your minor child/ward are physically fit and/or adequately skilled to perform the Volunteer Activities.  It is always advisable, especially if the participant is pregnant, disabled in any way or has recently suffered an illness, injury or impairment, to consult a physician before performing any Volunteer Activities that involve physical activity.

 

WARNING OF RISK

The Volunteer Activities often challenge and engage the physical, mental and/or emotional resources of each volunteer.  Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when acting as a volunteer for the Foundation.  All hazards and dangers cannot be foreseen.  Certain risks, dangers and injuries may exist due to slips and falls, poor skill level or conditioning, carelessness, horseplay, premises defects, inadequate or defective equipment, inadequate supervision, instruction and other risks inherent to the Volunteer Activities.  In this regard, it is impossible for the Foundation to guarantee absolute safety.

 

WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK

Please read this form carefully and be aware that in acting as a Foundation Volunteer, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of volunteering in any and all Volunteer Activities and/or Compassion (including transportation services and vehicle operations, when provided).

 

I recognize and acknowledge that there are certain risks of physical injury to volunteers providing and/or engaging in Volunteer Activities and/or Compassion, and I voluntarily agree to assume the full risk of any and all injuries, death, damages, or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said Volunteer Activities and/or Compassion.  I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to be or my child/ward) as a result of the Volunteer Activities, and/or Compassion, against the Foundation, or any of its affiliated organizations, or any of their respective officials, officers, employees, agents, and/or other volunteers, collectively or individually.

 

 

 

 

 

MEDIA AND TALENT WAIVER AND RELEASE

In consideration for the opportunity to appear in Foundation activities, I hereby authorize and consent to the unlimited reproduction, sale, licensing, broadcast, exhibition, use and/or distribution by Foundation of my video and film image(s), photograph(s) and/or my comments/quotes (collectively referred to as by “property”) in connection with services provided and/or products sold by Foundation, including, but not limited to, their use in connection with The Barnyard Foundation, in print, electronic and any other media, whether now or hereafter created, for advertising, promotion or any other legal purpose.  My consent also allows Foundation to make such changes as it deems desirable to my property, to use all or any part of the original or the modified form of my property, and to use my property alone or in conjunction with other photographs, sketches, drawings, recordings, artwork, text and any other material.  I waive all rights of inspection or approval of any such material.

 

I hereby assign all rights in and to such property, including all copyrights therein, to Foundation and irrevocably release Foundation, its assigns and their employees and agents from any and all claims or demands arising out of such use of my property.

 

I understand that signing this release in no way creates a contract of employment or a guarantee of continued employment with Foundation.

 

I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims.  If registering on line or via fax, my on-line or facsimile signature shall substitute for and have the same legal effect as an original form signature.

 

Participant’s Signature:                                                               Date:                                       

(Note: Participant must be 18 years or older, OR Parent/Guardian signature is required.  VOLUNTEER ACTIVITIES WILL BE DENIED if the signature of adult participant or parent/guardian and date are not on this waiver.)

 

Participant’s Address:                                                                                                                            

City:                                                                              State:                           Zip:                             

Phone #:                                                                       Cell #:                                                             

Emergency Contact:                                                                                                                              

Emergency Contact Phone 1:                                                      Phone 2:                                             

Emergency Contact Address:                                                                                                                 

City:                                                                              State:                           Zip:                             

 

First Volunteer Name

First Name*

Middle Name

Last Name*

Phone*
First Volunteer Date of Birth*
First Volunteer Signature*
Second Volunteer Name

First Name*

Middle Name

Last Name*
Second Volunteer Date of Birth*
Third Volunteer Name

First Name*

Middle Name

Last Name*
Third Volunteer Date of Birth*
Fourth Volunteer Name

First Name*

Middle Name

Last Name*
Fourth Volunteer Date of Birth*
Fifth Volunteer Name

First Name*

Middle Name

Last Name*
Fifth Volunteer Date of Birth*
Sixth Volunteer Name

First Name*

Middle Name

Last Name*
Sixth Volunteer Date of Birth*
Seventh Volunteer Name

First Name*

Middle Name

Last Name*
Seventh Volunteer Date of Birth*
Eighth Volunteer Name

First Name*

Middle Name

Last Name*
Eighth Volunteer Date of Birth*
Ninth Volunteer Name

First Name*

Middle Name

Last Name*
Ninth Volunteer Date of Birth*
Tenth Volunteer Name

First Name*

Middle Name

Last Name*
Tenth Volunteer Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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