Volunteer/Staff Information

Volunteer name:_______________________________________________Date:____________

Address:______________________________________________________________________

Date of Birth:______________ Age:___________Email:________________________________

Home Phone:_______________________________Cell Phone:__________________________

Employer/School:__________________________________Phone:_______________________

Address:______________________________________________________________________

Parent/Legal Guardian Name and Address:___________________________________________

_____________________________________________________________________________

Parent/Legal Guardian Phone if different:____________________________________________

How did you learn about Hooves to Heal, NFP?________________________________________

Tetanus Shot

A tetanus shot is highly recommended for all volunteers and staff working with the horses.

If you have a current tetanus shot please indicate the year the shot was received here:__________

If you decline your personal responsibility to obtain a tetanus shot, please initial here:___________

If you don’t have a current shot but plan to, please notify the Program Director when the shot has been received.

Do you have CPR or First Aid Training?:

CPR Adult [ ] Expires________ CPR Child [ ] Expires_______ First Aid [ ] Expires_______

Horse Experience:_______________________________________________________________

_____________________________________________________________________________

All horses are to be handled consistently with natural horsemanship methodology.

Please check areas of interest:
PROGRAM	SPECIAL EVENTS	ADMINISTRATION
∼ Horse preparation	∼ Horse Show	∼ Public relations
∼ Sidewalking	∼ Fundraising	∼ Grant Writing
∼ Horse leader	∼ Special Olympics	∼ Newsletter
∼ Arena crew	∼ Trail Rides	∼ Volunteer Recruiting
∼ Stable management	∼ Annual Events	∼ Volunteer Packages
∼ General maintenance		∼ Participant packages
∼ Facility repairs		∼ Mailings
∼ Improvements		∼ Photography/Video
		∼ Future Planning

Hours available: M________T________W________Th_______F_______S_______Su_______

Special skills (Also please describe any experience with the disabled):

_____________________________________________________________________________

_____________________________________________________________________________

I understand that my final placement as a volunteer to the Hooves o Heal, NFP program is contingent on my background check and my review at the end of the trial period. I understand the invaluable role I play as a volunteer to this program and therefore pledge to uphold my commitments to this program and the clients it serves. Furthermore, I agree to uphold all program standards and policies.

Signature:________________________________________________Date:_________________

(Volunteer/staff; signed in presence of center staff)