First name*:

 Middle initial*: 

  Last name*: 

Home phone*: 

Work phone*:

Cell phone*:

Address*:

City*:

Zip*:

Email*:

Phone*:

Emergency contact*:

Relationship*:

Skills and Interests

Highest level of education completed:

Previous work & volunteer experience:

Skills or hobbies:

Language(s) other than English:

What do you hope to gain from volunteering at the San Diego Natural History Museum?

How did you hear about our volunteer program?

ABCorg.comWebsite     Newspaper     CraigsList     Volunteer Match  
Internet Volunteer    Current Volunteer    Other (specify):

Have you participated in any of the following TCP programs?

40 day program     Online Courses    Classes    Volunteer Trips

Are you a member? yes

Availability

Weekdays    Weekends

Health Questions

Do you have:
Physical limitations?   Describe:
Severe allergies?   Explain:

References (non-relatives)

Name*:

Phone or email*:

Relationship:*

Volunteer Group of Interest (Please review descriptions and requirements before answering)

Horse Ranching, training

Animals

Ministry Ambassador

Administrative dept.

Guest Services 

Cafe Volunteer

Grounds Keeper (specify)

Unpaid Internship for course credit (requires additional steps)

Spring/Summer Camp Volunteer (ages 16 and up) *Must complete section below

Parent/Guardian's name:

Parent/Guardian's phone:

Comments (or additional relevant information):

RELEASE AND WAIVER OF LIABILITY

Pursuant to Title 3.1,Chapter 27.5, Code of Virginia (Sections 3.1-796.130, et seq), Being The Equine Activity Liability Act (hereinafter the act) the terms of which Act and the definitions contained in the Act being incorporated herein and made a part here of by reference, the undersigned participant of equine activities, including the riding of equines, for himself or herself, or in the case of a minor child, for such minor child as the parent or legal guardian of such minor child (all of whom are referred to collectively as the "participant", "participant meaning any person, whether armature or professional, who engages in an equine activity, whether or not a fee is paid to participate in the equine activity"), is hereby given all NOTICE and hereby acknowledges, understands and agrees that there are certain intrinsic dangers of equine activities (the term " intrinsic dangers of equine activities" means those dangers or conditions that are an integral part of equine activities, including but not limited to (i) the propensity of equines to behave in ways that may result in injury, harm or death to persons on or around them; (ii) the unpredictability of an equine's reaction to such things as sounds, sudden movement, and unfamiliar objects, persons, or other animals; (iii) certain hazards such as surface and sub surface conditions; (iv) collisions with other animals or objects; (v) the potential of a participant acting in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the equine or not acting within the participant's ability; further, the term "equine", for purposes of this document means a horse, pony, mule, donkey, and/or hinny), including the riding of equines, the equipment which may be used in riding equines, and the places where and circumstances under which equines may be ridden, which inherent dangers of equine activities the Participant accepts and expressly agrees to assume the risks thereof.  Further, in consideration of the Participant using the equines, equipment and/or property of Learning Park, Kaufmann Foundation, Taking Care of People.org., Stephen and Bonnie Kaufmann and any volunteers of any entities and any board members herein after called Learning Park, the Participant does for and on behalf of the Participant, the Participant's minor child or children who are Participant's who are parents, guardians, heirs, next of kin, beneficiaries, executors, administrators, successors, in interest, and assigns, waive, release discharge and quitclaim any and all claims, rights to sue, and demands any of the above referred persons may have, ever had, or may allege in any manner against Learning Park, it's owners, agents, employees, volunteers, representatives, board members, or officers ( all of whom are referred collectively as "Learning Park")  As a result of using the equines equipment and/or property of Learning Park, it being acknowledged understood and agreed that this is a complete, comprehensive and final release, discharge and quitclaim regarding the above referred matters, all as set forth in the Act, and in particular, section 3.1- 796-132 of the Act.  Further, the participant hereby grants full permission to Learning Park to use the Participant's likeness for any purpose including commercial advertising.  If the person using any of the horses equipment and/or property of Learning Park is under the age of 18 years, the parent or legal guardian of such minor child must sign this Release Waiver of Liability, and by such signature represents to all persons that the signatory is the parent or legal guardian of such minor child.

________________________________________________________

Signature of Participant or Parent or Legal Guardian of Participant if person

using the equines, equipment and or property of Learning Park is under the age of 18)

I understand and agree to the terms of this Guest Agreement and waiver of liability as a volunteer and/or guest on the property, and I have been provided and have read and understand the Orientation Rules for Volunteers and the Release and Waiver of Liability.

_________________________________ __________

Guest Date

_________________________________ __________

Guest Date

I hereby certify that all statements made in this application are complete and true, to the best of my knowledge. I understand as a condition of volunteering at the TakingCareOfPeople.org farm or Main street or internet ministry property are included in the orientation rules and guest agreement. I understand that my references will be verified and a background check performed.