Name *

Primary Phone Number *

E-mail (this is how our volunteer coordinator will contact you) *

Street Address *

City *

State *

Zip Code *

Are you 18 or older? (if yes, please provide copy of valid ID- please note that dog walkers at the shelter and dog handlers at events must be at least 18 years of age*) *

Yes

No

Volunteer Interests

1. What activities/services are you interested in? (mark all that apply) *

Walking shelter dogs (biggest need!)

Taking adoptable dogs to events (must have own transportation)

Transporting dogs to vet appointments

Transporting dogs to rescue

Dishes/Laundry/Kennel Cleaning/Chores at the shelter

Fundraising

Other Other

Tell us why you are interested in volunteering with FOSD, as well as any experience you have that may be helpful. *

What hours/days are you available to volunteer? *

Do you have any physical/health issues that may impact the capacity in which you can assist FOSD? *

Yes

No

If yes, please explain:

Name, phone, and e-mail of one personal reference. *

I understand that by agreeing to volunteer for Friend of the Shelter Dogs (FOSD) that my duties may involve me

interacting with animal(s). I hereby, for my heirs, my personal representatives, my family and myself represent and

warrant as follows:

I. I am fully aware of the risks that the type of animal(s) I may interact with pose, and I have elected to interact

with the animal(s) voluntarily. I knowingly assume all risks that exposure to animals may pose, including, but

not limited to, serious bodily injury and/or death.

II. I agree to assume all responsibility, liability, and risk arising out of engaging or participating in rescue,

adoption, and other activities while volunteering for FOSD and to hold its board members, staff, or other

volunteers or representatives not legally liable for any injury to person or property arising for any reason

whatsoever and assume all personal liability.

III. I understand that I am NOT covered under workers' compensation and also must provide my own insurance,

including medical and auto, for injuries or damage sustained while providing services for FOSD.

Note: If you work with the dogs at the Athens County Dog Shelter (ACDS), it is your responsibility to

complete and submit any forms required by the ACDS.

IV. I will allow FOSD to use my name, image, voice, words, or likeness in photo(s), video, or written text in

educational and promotional material. I waive any rights of privacy and/or publicity I may have in connection

therewith.

By typing your name in the box you are complying with this agreement. Also by submitting this form you will automatically be added to our volunteer contact list. *

Today's Date *