Volunteer Release - Mile High Canine Rescue

Volunteer Release Form

Date*
Date Format: MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Emergency Contact Name*
First Last
Emergency Contact Phone*
MHCR utilizes a Facebook group for our volunteers and fosters. Please enter your Facebook name below:*
How would you like to help?*
- Select All
- Perform home checks
- Help out at events
- Transport dogs locally
- Transporting dogs - longer trips
- Fostering (please do a foster application, as well)
- Grant writing or donation solicitation
Since you selected Home Checks, do you have a work address or a secondary address you visit frequently that we can save on our home check map?
Street Address Address Line 2 City State ZIP Code
How did you come to hear about MHCR*
If you were referred by someone, please provide their name.
I acknowledge that my services are provided strictly on a volunteer basis, there are inherent risks of injury, including physical harm caused by animals. On behalf of myself (and my minor children), I hereby release, discharge, and forever hold harmless MHCR, its directors, volunteers, successors, and assigns from any and all claims, causes of action, damages, or any nature of cause, including costs and attorneys fees incurred, based on damages or injuries in any way connected with services for MHCR, including but not limited to animal bites, accidents, illnesses, or injuries.*
- I agree
I understand that public relations are an important part of volunteering at MHCR. On behalf of myself (and my minor children), I allow MHCR to use any photographs of me or my family for public relations efforts. I will represent the rescue with the utmost of caution, class, and respect while performing services for MHCR and on my own social media networking sites.*
- I agree
Typing and signing my name below shall serve as my electronic signature. By signing such, I hereby give my consent to perform volunteer services for Mile High Canine Rescue, Inc. (herein referred to as MHCR). I fully understand and acknowledge that my services are to be performed subject to all rules and regulations (which may be modified from time to time), whether verbal or otherwise set by MHCR or its representatives. I understand that failure to do so may result in my immediate termination as a volunteer.*
First Last Date of Birth
Signature*