Name (required)
Address
Email (required)
Cell phone
Home phone
Skills and Educational Background
Locations Contra Costa CountyAlameda CountyMarin/Sonoma CountyYolo County Other
Days Available Mornings:MondayTuesdayWednesdayThursdayFridaySaturdaySunday Afternoons:MondayTuesdayWednesdayThursdayFridaySaturdaySunday How many hours are you available a month?
Do you have experience with horses? YesNo If yes, please describe your experience.
Do you have experience with working with older adults? YesNo If yes, please describe your experience.
Do you have any health limitations? YesNo If yes, please describe briefly.
How did you hear about Connected Horse?
Areas of Interest Program Administration Office WorkFundraisingEvent PlanningHosting an EventNewsletterBloggerSocial MediaCommunity OutreachPublic RelationsGrant WriterOther Workshops FacilitatorHorse HandlerWorkshop Set UpParticipant RecruitmentPhotographerVideographerParticipant companionOther
Volunteer Advisory and Release of Liability (required) As a volunteer 18 years an older, for Connected Horse, I understand and accept the risks and potential for risks of being around horses and participating in an equine assisted program. These risks were explained to me and I hereby intending to be legally bound for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Connected Horse, its Board of Directors, Instructors, Volunteers, Facilitators, and/or Employees for any and all injuries and/or losses I may sustain while participating at a Connected Horse activity, workshop or event.
Photo Release (optional) I consent to and authorize the use and reproduction by Connected Horse and its partners of any and all photographs, videos and any other audiovisual materials taken of me as part of the Connected Horse program for promotional purposes, educational activities, exhibitions, research or for any other use for the benefit of the program.
Confidentiality Agreement (required) I understand that all information about participants at Connected Horse programs or participants of Connected Horse partners is confidential and will not be shared with anyone without express written consent of the participant or their responsible party. I agree to keep all information about participants confidential.
Note: consult your physician regarding any restrictions or limitations regarding volunteer activities and to ensure you are current with vaccinations such as tetanus and T.B.
The information I have provided to the best of my knowledge is accurate and complete. (required)
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