Desert Pines Horse Rescue - Volunteer Form

Date _____________________

Name _______________________________________________Volunteer Name _______________________________

Address ______________________________________________ City _______________ State _______ Zip _______

Home Phone: _____________ Work Phone:_______________ E-mail: ________________________________

Current Occupation: (Past occupation if retired): ______________________________________________

How did you hear about Desert Pines Horse Rescue? _________________________________________

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Preferred Tasks

_____Grooming/Saddling _____Barn Chores _____Exercising/Training _____Fundraising/Outreach

Do you have horse experience? If so, describe your experience (beginner, intermediate, advanced)?

_____Yes   _____No    __________________________________________________________________________________________

Have you volunteered for an animal rescue before? If yes... where?_______________ How long?________

______Yes _____No ___________________________________________________________________________________________

Have you ever been charged or convicted of animal cruelty? If yes, please explain.

_____Yes _____No ____________________________________________________________________________________________

Additional information you would like to share, such as your education, general interests/hobbies, to help us get to know you better ___________________________________________________ ______________________________________________________________________________

What would you like to gain from volunteering at Desert Pines Horse Rescue?

__________________________________________________________________________________________________________________________________

Is there anything else you would like to share?

__________________________________________________________________________________________________________________________________

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Availability and Volunteer Assignment Preferences

I Am Available:

Mornings (Mon-Fri)_________________________________ 

Afternoons (Mon-Fri)_______________________________ 

Evenings (Mon-Fri)__________________________________ 

Weekends_________________________________________________

Once A Week____________________________________________

More Than Once A Week______________________________

One Time Only As Needed______________________________

Special Notes: _________________________________________________________________

Do You Have Any Physical Condition that May Limit Your Activities? _____Yes _____No

If Yes, Describe: _______________________________________________________________

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Please list two references we may call, including family and friends, one of whom may be your religious or spiritual leader, teacher, employer, etc.

Name ______________________________________________ Phone _________________________

Address ________________________________City ___________State _______Zip ________

Relationship ________________________________________________________________________

Name ______________________________________________ Phone ________________________

Address ________________________________City ___________State _______Zip _________

Relationship ________________________________________________________________________

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Release and Hold Harmless Agreement

I ________________________________am a volunteer at Desert Pines Horse Rescue who agrees to any or all of the following: 

Grooming/Saddling, Barn Chores/Cleaning, Exercising/Training horses on the ground and in the saddle, (which depends upon experience and director approval) Fundraising/Outreach and more. Volunteers may be asked to assist with visitors...

I understand that my participation and/or involvement in working with/being around the horses or riding on any of the horses at the facility or away from the facility, carries with it the potential for certain risks, some of which may not be reasonably foreseeable.

I further acknowledge that these risks could cause me, or others around me, including, but not limited to, bodily injury, damage to property, emotional distress, or death.

By signing this agreement, I agree to release indemnify, and hold harmless Desert Pines Horse Rescue as well as their/its owners, employees, agents, representatives, successors, family, etc. from all losses, claims, theft demands, liabilities, causes of action, or expenses, known or unknown, arising out of my participation with/and/or around all horses on and off the facility properties.

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Please read Desert Pines Horse Rescue - Barn Policies, Rules and Regulations

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Applicant - Printed Name__________________________________________ Volunteer - Printed Name _____________________________

Parent/Legal Guardian Signature________________________________ Volunteer - Signature ____________________________________

Emergency Contact Name*__________________________________________ Owner/Director - Printed Name ______________________

Emergency Contact Phone Number*________________________________Owner/Director - Phone Number______________________

Email completed form to DesertPinesHorseRescue@yahoo.com

Desert Pines Horse Rescue - Deb Collings - 3305 Sun Cloud Circle - Reno, NV 89506 - 775-771-9162

DesertPinesHorseRescue.com