Darlynn's Darlins Inc.

"The way we treat the others is the way we will ultimately treat each other." - Darlynn

"When you change the way you look at things, the things you look at change." - Wayne Dyer

Volunteer Application

 

Name:  _____________________________________  Last 4 of SSN:  _______________

Address:  ___________________________________  City:  ______________________

State:  _____  Zip:  _________  Phone: _______________

 

Emergency Contact:  ______________________________________________________ 

Relationship:  _____________________________  Phone:  ________________________

 

Reference (non relative):  ___________________________________________________ 

Relationship:  _________________________  Phone:  ____________________________

Reference (non relative):  ___________________________________________________ 

Relationship:  _________________________  Phone:  ____________________________

 

Reason for Volunteering (court ordered community service hours, school, etc.): 

_______________________________________________

 

School Contact Name:  ________________________________________________ 

Phone:  ______________________

Community Control Officer Name:  _______________________________________

Phone:  ______________________ 

Are you covered by insurance for your service hours through private insurance, school insurance, or the department of corrections? ______

  

The above information will be used to determine eligibility to volunteer at Darlynn's Darlins Rescue Ranch Inc., will be kept on file, and will not be shared with anyone.  Volunteers should be of legal age (18) and have reliable transportation.  A signed release and waiver of liability is required for all volunteers.  Exceptions may be made to accommodate volunteers under the age of 18 if a parent or legal guardian can be present during the volunteer hours. 

If offered a volunteer position and hours are agreed upon, it is understood that the volunteer will be expected to be punctual and to work the assigned hours except in the case of an emergency or illness. Further, they will notify Darlynn's Darlins Rescue Ranch if unable meet their obligation as soon as possible so that arrangements can be made to accomplish their assigned tasks. Non adherence to this policy could result in volunteer disqualification. If a volunteer is under the age of 18, a parent or legal  guardian is required to sign the release and wavier of liability on their behalf, be present on premises during their service, and assume 100% responsibility for their safety.

If approved, please print a copy of this form for your own records and have a signed original for us when you come for orientation.



RELEASE AND WAIVER OF LIABILITY

 

I understand and agree that my participation in Darlynn's Darlins Rescue Ranch Inc., activities and animal interactions are entirely at my own risk.

Initial:  _____

I agree and release from all liability whatsoever and hold harmless all named and un-named members of Darlynn's Darlins Rescue Ranch Inc., the property owner, and all other volunteers from any manner of injury or harm which I may sustain from any cause or in any manner whatsoever while on the property located at 9830 Evans Road, Polk City, FL 33868, or while a participant on behalf of Darlynn's Darlins Rescue Ranch Inc., in any event held elsewhere.               

Initial:  _____

I understand that Darlynn's Darlins Rescue Ranch Inc., carries NO Liability Insurance and that Darlynn Czerner, Clinton Martin, and the property owner where DDRR Inc is located, are unable to obtain either Premises or Content Liability Insurance

Initial:  _____

 

My signature below is verification that I have read, fully understand, and fully accept all risks, stated or unstated, that may be involved or occur while participating in any and all activities associated with Darlynn's Darlins Rescue Ranch Inc.

 

Signature:  ___________________________________________ 

Date:  _____________

Witness:  ____________________________________________

Guardian Signature:  _________________________________ 

Date:  _____________

 

Witness:  _____________________________  Date: ____________ 

Witness:  _____________________________  Date:  ___________