Chesapeake Shepherd & K-9 Rescue, Inc.

Volunteer Application

Personal Information (Note: Applicants must be at least 18 years of age)
First Name:	Last Name:
Street Address:
City:	State:	Zip:
Home Phone:	Work Phone:	Cell Phone:
Email:

Occupation:
Special Interests/Hobbies/Skills:
Please describe your experience with dogs including breed types and any other pertinent dog related information:
Please use the space below to share any other information which you think is relevant or important about yourself:

Please check all areas of interest below:
Providing Foster Care (Please complete foster application)	Merchandising
Temporary/Emergency (short term) foster care	Publicity/Public Relations/Advertising
Handling dogs at "Meet 'n Greet" days or other events	Write articles for the Newsletter
Evaluate dogs for temperament	Help organize special events
Transportation of dogs	Grant Research/Proposal
Training/Obedience	Fundraising
Grooming	Donation Solicitation
Reference/Vet checks on adoption applications	Home Visits for potential adopters
Other ideas/areas for helping the rescue: (please specify)

Foster Home Information
Please fill out this section if you are interested/willing to foster even on an emergency basis.
Thank you!

Veterinarian Information
Vet's Name:
Clinic Name:
Street Address:
City:	State:	Zip:
Phone:

Household/Family Information

Have you ever fostered dog(s) for another rescue? Yes No

Please list all dogs presently living with you:

Name	Breed	Sex	Age	Spayed or Neutered?
		M F		Y N
		M F		Y N
		M F		Y N
		M F		Y N

Do your pets get along with visiting animals? Yes No

Do you have any cats? Yes No

Please list all residents of your household:

Name:	Age:
Name:	Age:
Name:	Age:
Name:	Age:

Do you have any small children? Yes No

If you have children, what is their experience with dogs? (check all that apply)
N/A Lived With Frequent Some None Large dog Small dog

Dwelling Information
Type of dwelling: Single family Townhouse Apartment Condo
Do you: Own Rent
If you rent, is there a weight limit on dogs in your rental property? Yes No
If you rent, landlord's name:	Phone Number:
(Note: Your application will be denied if we cannot reach your landlord after repeated attempts)
If you have a yard, is it fenced? Yes No
If yes, height and material:
If no, how will you handle exercise and toilet duties?

Living Conditions Information
Approximately how many hours per day will your dog be alone?
Where will your dog spend time when you are not home? (Check all applicable): Open home Crate Kennel Fenced yard Other
Where will your dog sleep?
What traits would make a dog ineligible to be a foster dog at your home?
Please describe the type of dog you would be most comfortable fostering:
Please list any other information that you feel is pertinent:

Please list the name of three references (not family members):
Name:	Phone:
Name:	Phone:
Name:	Phone:


Terms of Agreement

Thank you for your interest in helping Chesapeake Shepherd & K-9 Rescue, Inc. Please allow 1-3 weeks for the processing of your application. If you are approved, you will be contacted by a volunteer coordinator to discuss your interests. If you have not heard from us within 3 weeks, please consider your application denied.

1.	I will abide by the mission, rules, regulations, policies and programs of Chesapeake Shepherd & K-9 Rescue, Inc. as long as I am a volunteer.

2.	I assume all risks of all personal injuries and property damage, including but not limited to being bitten, scratched, or otherwise injured in connection with my volunteer work for Chesapeake Shepherd & K-9 Rescue, Inc. (CSK9). CSK9 is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with the performance of my volunteer activities for CSK9, including those caused by CSK9's negligence (but not by CSK9's intentional misconduct). I will indemnify, defend and hold CSK9, and its agents, guests and other volunteers, harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any animal or any person, in connection with my performance of volunteer activities for CSK9, or my breach of CSK9's rules, regulations, policies and programs.

3.	I understand and agree that CSK9 may refuse volunteer applications for any reason.

4.	I understand and agree that CSK9 may refuse foster home applications for any reason.

5.	I understand and agree that CSK9 may terminate volunteer status, privileges and support for any reason.

6.	I understand and agree that CSK9 may terminate foster status, privileges and support for any reason.

7.	I understand that working with stray and abandoned animals carries risks. CSK9 cannot predict the temperament of any dog and cannot guarantee that the dog may not become aggressive. Therefore, I understand that I am assuming certain rists if I agree to work directly with the dogs. I have acknowledged these potential risks before deciding in which volunteer activities I would like to participate.

8.	I assume all risks of personal injuries and property damage caused by any foster dog within my care for CSK9. I will, to the best of my abilities, take proper care of any foster dog and follow all CSK9 rules and procedures, including but not limited to obtaining approval for veterinary services for the foster dog, family integration of the foster dog and having the dog presentable for meeting prospective adoptors.

9.	I have accurately completed this volunteer application and have read and agree to the above liability hold harmless waiver as well as the above warning and appreciate the risks involved in working with dogs.


I understand that CSK9 cannot be responsible for the actions, behavior and/or medical condition of all of the dogs which it seeks to rescue and I agree to assume the risks implicit in working with dogs who may have been abandoned, beaten or otherwise mistreated or abused, or who may suffer from an illness, condition or disease.


Applicant Signature:	Date:
Witness Signature:	Date:


I hereby consent to , a minor, volunteering with CSK9, and to his/her assumption of all risks thereof, including those described above. I agree, personally and on his/her behalf, to waive any and all claims which I or he/she may now or hereafter have against CSK9, and will indemnify, defend and hold CSK9, and its agents, guests and other volunteers, harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any animal or any person, in connection with said minor's performance of volunteer activities for CSK9, or his/her breech of CSK9's rules, regulations, policies and programs.

Parent/Guardian Signature:	Date:

"A harbor, even if it is a little harbor, is a good thing, since adventures come into it as well as go out, and the life in it grows strong, because it takes something from the world and has something to give in return." -Sarah Orne Jewett, from "River Driftwood" (1881)