Sioux Empire Pit Rescue Volunteer Application

Sioux Empire Pit Rescue is seeking volunteers 21 years and older to help out with the organization. Please fill in the information below to indicate how you would like to become involved.

Last Name *

First Name *

Street Address *

City *

State *

Zip Code *

Email Address *

Main Phone # *

Alternate Phone# *

What is your age range? **Currently not accepting new volunteers under the age of 21** *

Do you own pets? *

Yes

No

Please tell us about your pets. Type, breed, age, etc.

Dogs/what kind/age: *

Cats/what kind/age: *

Are they spayed/neutered? (Note all current household pets must be spayed/neutered) *

Yes

No

If not spayed/neutered is there a reason? (please explain) If not spayed/neutered is there a reason? (please explain)

Are they current on vacinations? *

Yes

No

Other (please explain) Other (please explain)

References: please supply the name and phone number of your current veterinarian or the one who saw your previous pet(s), with their title identification. (***All personal pets must be spayed/neutered and up to date on all vaccinations to become an active SEPR volunteer.) *

Have you done breed research about the terrier breed/pit bulls? If yes, what kind and what have you learned about this breed that would be helpful to you in volunteering? *

Have you had experience in care/training/dog walking? Please explain: *

Please tell us about yourself and your interest in the breed, why you want to help Pit Bulls in need, what experience do your currently have, etc. *

What areas of work would you be interested in (check all that apply)? *

Please tell us about your availability and how many hours a week you can dedicate to SEPR
*

Where did you find out about this opportunity?
*

Comments/Additional Information *

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

By checking YES I hereby release and forever discharge and hold harmless SEPR, 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 SEPR 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 SEPR from any liability or claim that I may have against SEPR 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 SEPR 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 SEPR and/or any project, activity, dog caretaking, or event sponsored, managed, arranged, promoted by, or otherwise affiliated or associated with SEPR 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 SEPR 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 South Dakota. 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

Sioux Empire Pit Rescue thanks you for your interest in being a volunteer. We need more responsible people that understand dogs are like children; they are not always perfect! We need to give them a lot of love and attention showing them right from wrong. We look forward to saving more of this misunderstood breed with help from all of you!