This form is to be completed by the parent or legal guardian (and child) of a child under the age of 18. PAWS policies prohibit children under 18 from volunteering unless accompanied and supervised by a parent, legal guardian, or an authorized "Responsible Adult" (21 or older). For this reason, either you or your authorized "Responsible Adults" must also complete the PAWS Volunteer Application and Agreement Form.

Information About the Volunteering Child

Contact information is for record-keeping purposes only; youth volunteers will not be contacted directly.

First name:

Last name:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Email address:

Date of birth:

Gender:

Responsible Adults (21 or Older)

All youth volunteers must have a Responsible Adult (21 or older) with them. Please list the names of the Responsible Adults who may volunteer with the child. Each person listed must also fill out the Adult Volunteer Application Form & Agreement and attend any required PAWS trainings, such as cat or dog volunteer training.

Parent/Legal Guardian

The parent or legal guardian filling the form out should list their name here. If the parent/legal guardian is not to be the Responsible Adult who volunteers with the child, please also list his or her email, address, and phone number. The Adult Volunteer Application Form & Agreement does not have to be filled out for a parent/legal guardian who will not be accompanying the child.

Allergies

Information for record-keeping purposes only. Discuss any allergies with your trainers and shift leaders.

List any allergies, including peanuts, latex, dogs or cats.

Volunteering for Credit

Is the child volunteering to earn credit in a class or for school? If so, is volunteering required or optional?

Special Needs

Does the child have any special needs that would affect their volunteering at PAWS? If so, and if they have a coach or someone else who should be contacted, please let us know.

Other Information

Information for record-keeping purposes only.

List any other information you would like us to know, such as the child's experience with cats and dogs.

Agreement

I have accurately and truthfully completed this Youth Volunteer Permission AND Release Form. In consideration for this opportunity for my child or children (“my children”), I agree to the following terms and conditions, intending to be legally bound by them:

1) PAWS POLICIES: I will instruct my children to at all times abide by the mission, rules, regulations, policies, and programs of PAWS while they are volunteers.

2) SUPERVISION OF CHILDREN WHILE VOLUNTEERING: When my children volunteer with PAWS, I will ensure that they are accompanied and supervised either by myself or by one of the Responsible Adults listed above. I agree that I will not allow my children to volunteer or attempt to volunteer without this required accompaniment and supervision.

3) ASSUMPTION OF RISK, LIMITATION OF LIABILITY & INDEMNIFICATION: I knowingly assume the risks of my children being injured or suffering damages (including but not limited to being bitten, scratched, frightened, or otherwise harmed) in connection with their volunteer work with PAWS. Neither PAWS nor its directors, officers, employees, agents, or volunteers, or its and their heirs, assigns, successors, personal representatives and executors, are liable to me or my children for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which my children might suffer or sustain in connection with the performance of volunteer activities. I will indemnify, defend and hold harmless PAWS, its directors, officers, employees, agents, and volunteers, and its and their heirs, assigns, successors, personal representatives and executors, from and against any claims, lawsuits, injuries, damages, losses, judgments, costs or expenses whatsoever, sustained by my child, any companion animal, or any person in connection with my children’s volunteering with PAWS.

4) GENERAL

a) Any modification to this Agreement must be in writing and signed by both parties. This Agreement is binding upon your and our heirs, assigns, successors, personal representatives and executors.

b) The terms and conditions contained in this Youth Volunteer Permission and Release Form are binding upon me, my spouse/partner, and my and his/her respective heirs, assigns, successors, personal representatives and executors.

I Agree