Volunteer Application Step 1 of 4 25% Contact InformationName* First Last Name Of Minor Child (If Applicable) First Last DOB*DOB Of Minor Child (If Applicable)Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address Of Minor Child (If Applicable) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneWork PhoneEmail* Emergency Contact Name*Emergency Contact Number* ExperienceWould you be interested in fostering?*YesNoA home which provides a safe, temporary living situation. The foster family provides accommodations, food, water, regular appropriate exercise, love and attention. HPA will cover medical costs at our approved vet partners. Fostering can take 4 - 12 weeks.How much time are you able to give?*I’m dedicated, whatever is needed2-4 hours per week4 hours per monthSpecial events or projects only*To remain an active volunteer, you must commit to at least 4 hours per month.What interests you?*CatteryCommunity Cat ProgramDog Adoption EventsTransportFoster CoordinatingMedical Coordinating for FostersHurricane Harvey ShelterOtherIf Other, specify Excluding traffic violations, have you ever been convicted of any criminal offenses?*YesNoDo you give permission to use photographs and/or quotes?*Yes, HPA! does have permission to use photographs/quotes of/by you or your minor child on our website, blog, or other marketingNo, HPA! does not have permission to use photographs/quotes of/by you or your minor child on our website, blog, or other marketingCan we add your email to our server list?*YesNoIt will not be shared outside of HPA! or posted publicly.How did you hear about us?*HPA! WebsiteFacebookInternet SearchPet Store or Adoption EventFriend/FamilyRescue CommunityCraigslistFlyerPetfinder.comNewspaperOther I agree, attest to, and certify that the above information is true and correct.*YesNo EXPECTATION FOR BEHAVIOR OF VOLUNTEERS AT BARC AND HARRIS COUNTY PHES VETERINARY SHELTER BARC and Harris County PHES Veterinary shelter are open- admission animal control facilities. The city has invited HPA! in to the shelter to help more animals leave alive. Animal Control is much different than animal welfare. It is critical to understand that the function of Animal Control is to protect the public first, and to help animals second. There may be actions that you witness that you do not agree with. It is critical that you do not intervene in any situation at either shelter. If you have a concern, please write it down and email it to Andrea Birkelbach (Andrea@houstonpetsalive.org) so that she can address the concerns or issues with shelter supervisors, if appropriate. HPA! is here to help animals leave the shelter alive, and we can’t do that if we get at cross- purposes with the shelter staff or animal control officers. First and foremost, we all must work together to accomplish great things. It is grounds for termination if any altercations occur between HPA! volunteers and shelter staff/ volunteers or if any negative publicity is produced in person or through public or private social media that could tarnish the reputation of these shelters, its staff or volunteers. I understand that the good relationship between these two shelters and HPA! is critical to making Houston a No Kill City and that I cannot cause any kind of negative issue while I am at either shelter representing HPA!. I agree to the above terms*YesNoVOLUNTEER AGREEMENT: In consideration of this opportunity to volunteer for Houston Pets Alive! ("HPA!"), I agree to the following terms and conditions:* I have been provided and will abide by the mission, rules, regulations, policies and programs of HPA! while I am a volunteer. I agree to be supervised by an HPA! Manager or designee and will work as a team member with all volunteers. I will treat all animals, other volunteers, and the general public with dignity and respect. If I will be sheltering or providing foster care or boarding for any of the HPA! animals in my home, I consent to an HPA! representative visiting my home from time to time to observe the animals and their living quarters. I have accurately and truthfully completed this Volunteer Application and Agreement. I understand that all HPA! volunteers must be at least 18 years of age or accompanied by a parent or guardian at all times. VOLUNTEER RELEASE AND WAIVER: Please Check off all agreements and acknowledgements:* I understand and agree that as a volunteer for Houston Pets Alive! (herein after referred to as HPA!") I assume all risks of loss or injury, including death to myself or damage to my property while on the property of HPA! and elsewhere, while participating in the volunteer program. I understand and agree that all services performed by me will be performed on a strictly voluntary basis, and that I will receive no remuneration, pay or compensation of any kind. I understand and agree that I will not be an employee of HPA! and will not receive any benefits normally available to employees of HPA!. I understand and agree that HPA! shall incur no liability of any nature as result of my volunteering for HPA!. I understand that in handling animals and performing other volunteer tasks there is a risk of injury, including physical harm or death, and that all services performed by me will be done at my own risk. I understand HPA! strongly recommends that I keep current my tetanus immunization. I further understand that HPA! recommends that any dogs and cats that I live with should be immunized by my veterinarian, and that these immunizations remain up-to-date during the time that I volunteer for HPA!. THEREFORE, ON BEHALF OF MYSELF, MY HEIRS AND PERSONAL REPRESENTATIVES, I HEREBY RELEASE, DISCHARGE AND INDEMNIFY AND HOLD HARMLESS HPA! THEIR ASSIGNS, SUCCESSORS, AGENTS, STAFF, OFFICERS, BOARD OF DIRECTORS, EMPLOYEES, CONTRACTORS AND REPRESENTATIVES FROM ANY AND ALL CLAIMS, CAUSES OF ACTION OR DEMANDS OF ANY NATURE OR CAUSE WHATSOEVER, REGARDLESS OF WHETHER OR NOT CAUSED WHOLLY OR IN PART BY THE NEGLIGNECE OF HPA!, INCLUDING COSTS AND LEGAL FEES ARISING OUT OF, OR RELATING TO, MY VOLUNTEERING WITH HPA!, INCLUDING, BUT NOT LIMITED TO, ANIMAL BITES, DISEASE, ACCIDENTS, PROPERTY DAMAGE, OR INJURIES. Signature*Date* EmailThis field is for validation purposes and should be left unchanged.