Let’s work togetherInterested in volunteering? Fill out some info and we will be in touch shortly! We can't wait to hear from you! Open Volunteer Form Volunteer Form Name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Drivers License State * Drivers License Number * Have you ever been convicted of a crime? * Yes No If "Yes", please explain Parent or Legal Guardian Telephone Number Parent or Legal Guardian Email Employer or School * Which position(s) are you interested in? * Horse Leader Sidewalker Groom Special Events Other What special talents would you like to share? * Please describe your current health status, particularly regarding the physical/emotional demands of working in an equine assisted program. Address fitness cardiac, respiratory, bone or joint function, recent hospitalizations/surgeries or lifestyle changes: * Allergies and Medications: * Tetanus shot and Tuberculosis Test: * Yes No N/A I consent to, and authorize the use and reproduction of photo, video, audio and visual of my likeness to be used for educational and promotional benefit to the program: * Yes No I authorize EquiHope to receive information from any law enforcement agency, including police departments and sheriff’s departments, of this state or any other state or federal government, to the extent permitted by state and federal law, pertaining to any convictions I may have had for violations of state or federal criminal laws, including but not limited to convictions for crimes committed upon child or animals. * Yes No I understand that such access is for the purpose of considering my application as an employee/volunteer, and I expressly Do NOT authorize the PATH Intl. Center its directors officers, employees, or other volunteers to disseminate this information in any way to any other individuals groups, agency, organization, or corporation. * Yes No I understand that all information (written and verbal) about participants at this PATH Intl. Center is confidential and will not be shared with anyone without the expressed written consent of the participant and his/her parent/guardian in the case of a minor. Yes No EquiHope, its officers members, employees contractors, and property owners and agents will not be responsible for any damages to person animal or property at the EquiHope leased or owned facility or its grounds nor will they be responsible for any property lost or destroyed. The undersigned rider/parent/guardian/volunteer hereby releases EquiHope, its officers, members, employees, contractors property owners and agents from any and all liability, claims and damages whatsoever (including costs, expenses, and attorney’s fees) that might result from damages, injuries, or losses to their person or property during, or in connection with, or arising out of any show clinic, event or function whether or not such damages injuries or losses result directly or indirectly from the negligent act or omission of such released parties. WARNING: UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.in exchange for the use of property leased or owned by EquiHope and other valuable consideration, I agree that use my use of the premises and any animals, facilities, or equipment leased or owned by EquiHope is at my own risk. I further agree to indemnify and hold harmless EquiHope, their respective officers members, employees, contractors, property owners and agents from ant and all suits actions or claims of any type arising from my use of the premises or participation in the equine activity of such use by my guest, whether or not such claims result directly or indirectly from the negligent act or omissions of the indemnified parties or otherwise. I acknowledge that riding and involvement with horses is a high-risk activity. I have read this agreement and fully understand its content. * * Yes No Thank you for your submission. We will be in contact soon via text or phone call.
