Volunteer Sign-up Form

4400 Raytown Road, KCMO, 64129
Phone: (816) 921-0201
email@petshalfwayhome.com

Halfway Home Pet Adoptions is seeking volunteers to assist the organization with a wide variety of tasks.
Please fill in the information below to indicate how you would like to become involved.

* Last Name

* First Name

* Street Address

* City

* State

* Postal Code

* Primary Phone Number

Alternate Phone Number

* Email Address

* Best Time to Contact

* Your Age Range

* Emergency Contact - Name and phone number

* Do you own any pets?

Yes

No

If you own any pets, please tell us about them:

0/500 words

Volunteer Experience

* Please tell us about yourself and why you are interested in volunteering with our organization:

0/500 words

* I am comfortable working with: (Check all that apply)

* What kind of volunteer opportunities would
you be interested in? (check all that apply)

* Tell us about your availability. How many hours
per week could you commit to volunteer work?

* Can you lift or carry heavy items

Yes

No

Up to 50 lbs

* Do you have any disabilitites

Yes

No

If so, explain

* Where did you find out about this opportunity?

Additional comments or information (let us know about any special skills, experience, health concerns, or any other information that may help us find the best volunteer role for you):

*

By checking YES I hereby acknowledge that any services I provide to Halfway Home Pet Adoptions (hereinafter HHPA) are done so on a volunteer basis, without pay or compensation of any kind and without liability of any nature on behalf of HHPA. I also acknowledge that all services performed by me for HHPA are done so at my own risk.

By checking YES I hereby release and forever discharge and hold harmless HHPA, its agents, officers, board of directors and member volunteers from any and all liability claims, demands and causes of action, of whatever kind or nature, either in law or equity, which have now arisen or may hereafter arise from my participation with HHPA including those arising out of negligent or intentional acts of the parties hereby released.

By checking YES I understand and acknowledge that this Release discharges HHPA from any liability or claim that I may have against HHPA with respect to any bodily injury or other injury, illness, death or property damage that may result from my duties as a volunteer. I also understand that HHPA does not assume any responsibility or obligation to provide financial assistance or other assistance including, but not limited to, medical, health or disability insurance in the event of injury, illness, death or property damage.

By checking YES I understand that my participation with HHPA and/or any project, activity, dog caretaking, or event sponsored, managed, arranged, promoted by, or otherwise affiliated or associated with HHPA may include activities that may be hazardous to me. I further recognize and understand that such participation may involve certain inherently dangerous activities. I hereby expressly and specifically assume the risk of injury or harm in the activities and release HHPA from all liability for injury, illness, death and/or property damage that may result.

By checking YES I expressly understand and agree that this Release is intended to be as broad and inclusive as permitted by law, and that this Release shall be governed by and interpreted in accordance with the laws of Missouri. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release.

YES

NO

* Indicates Response Required

Halfway Home Pet Adoptions is seeking volunteers to assist the organization with a wide variety of tasks. Please fill in the information below to indicate how you would like to become involved.

Halfway Home Pet Adoptions is seeking volunteers to assist the organization with a wide variety of tasks.
Please fill in the information below to indicate how you would like to become involved.