First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Why would you like to volunteer with TLC Animal Rescue?*

Do you volunteer with any other rescue organizations?

If yes please list the organization and your role with them.

Employer and job title*

May we contact as a reference?

Please provide you date of birth.*

Please provide age and breed of any pets in home.*

Animal Experience (check all that apply)

Other Experience, Special Skills, Strengths, Talents (Check all that apply)

Volunteer Preferences (Check all that apply)

How much time can you commit?*

What days/time of day are you available?*

Please list 2 references (only one family member) include, name, phone number and email.*

I have freely elected to participate strictly at my own risk in TLC Animal Rescue Volunteer Program. In the event of any bodily injury during my participation in the Volunteer Program, I agree to hold TLCAR, their associates, agents, servants, representatives, successors and assigns harmless from and against any and all claims, damages, losses, and expenses, arising out of the Volunteer Program, including, but not limited to claims for bodily injury, illness, or death, including loss of use of any bodily parts as a result thereof, whether or not caused in whole or in part by TLCAR negligent act or omission, or that of any of its servants or associates, or that of any other person for whose acts TLCAR may be liable. However, this hold harmless agreement shall not waive my rights, if any, for coverage and/or payment under my health benefit plan and/or HMO. I have read the above statement. I understand it, and my selected Accept Terms confirms its full acceptance. I attest and verify that I am physically fit and sufficiently trained to participate in such event.