[City of Pocatello] Zoo Idaho Volunteer Application and Waiver

Zoo Idaho Volunteer Application and Waiver

Volunteer Information

Cell Phone

Age Group

Youth (14–17)

Adult (18+)

Parents/Guardians

(1) Parent's/Guardian's Number

(2) Parent's/Guardian's Number

Other Emergency Contact

Emergency Contact

Emergency Contact Phone

Relationship to Emergency Contact

School Information

Are you a home school student?

Yes

School Name

School Activities

GPA

Are you employed outside of school?

Yes

Pet Information

What pets do you have?

Volunteering Information

Reason for Volunteering

How did you hear about the youth volunteer program?

Why do you want to be a youth volunteer?

Do you have any previous volunteer experience?

Yes

Please describe your previous volunteer experience.

Do you have any animal handling experience?

Yes

Please describe your animal handling experience.

Do you have any experience working with children?

Yes

Please describe your experience working with children.

Please list any special skills you have (multilingual, graphic design, event planning, construction, certifications/licenses).

What are your hobbies?

Describe any special talents you have.

Describe any theater experience you have.

Please list any physical conditions we should be aware of in case of an emergency (such as plant, animal, or food allergies; a heart condition; etc.).

Please indicate which of the following volunteer programs interest you.

Education Aide

Events Volunteer

Zoo Naturalist

Zookeeping Aide

Background Information

Have you ever been convicted of a criminal offense?

Yes

Please explain your conviction of a criminal offense.

Have you ever been charged with child or animal neglect, abuse, or assault?

Yes

NOTE: Due to City of Pocatello policy, a background check is required for everyone who comes in contact with children.

Waiver

VOLUNTEER RELEASE & MEDICAL AUTHORIZATION AGREEMENT ASSUMING RISK OF INJURY OR DAMAGE, WAIVER AND RELEASE OF CLAIMS INDEMNITY AGREEMENT, AND AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT.

WHEREAS, I BEING over the age of eighteen (18) years of age and not being an employee of the City of Pocatello, a municipal corporation, (hereinafter referred to as the City of Pocatello), have made a voluntary request to work, without being paid compensation, at the Zoo owned and operated by the City of Pocatello, and

WHEREAS, the City of Pocatello is willing to permit me to work without compensation, as a volunteer at the Zoo owned and operated by the City of Pocatello based upon the conditions and understanding stated below.

NOW, THEREFORE, in consideration of the permission given to me to work without compensation as a voluntary at the Zoo owned and operated by the City of Pocatello, I do hereby agree:

1) That I am aware that the work and the animals at the Zoo owned and operated by the City of Pocatello are inherently dangerous and that I may be subjected to risk of death or personal injury or damage to my property as a volunteer worker, and that I freely, voluntarily, and with such knowledge assume the risk of death, personal injury, or property damage arising from or in any way connected with the animals at the Zoo, the work to be performed by me, the supervision or assignment of the work to be performed by me, or the conditions of the Zoo premises.

2) That the City of Pocatello, its elected officials, supervisors, employees, servants, agents, their sureties and each of them, shall not be responsible or liable for injury, loss, or expense either to me or my property, incurred while working as a volunteer without compensation at the Zoo owned and operated by the City of Pocatello, resulting from any negligent act or omission on the part of any employee or employees at the City of Pocatello.

3) For myself, my heirs, my executors, administrators and assigns to defend and indemnify the City of Pocatello, and each of them against any and all manner of actions, causes of action, suits, debts, claims, demands, or damages, or liability expense of every kind of nature incurred or arising by reason of claimed negligent or wrongful act or omission of mine while working without compensation as a volunteer for the Zoo owned and operated by the City of Pocatello.

4) The volunteer or his/her parent or guardian hereby specifically authorizes the staff of the City of Pocatello to procure transportation for the volunteer to the nearest hospital and its medical personnel to administer necessary emergency professional medical care to the below named volunteer upon his/her arrival at the hospital.

I HEREBY REPRESENT THAT I HAVE CAREFULLY READ AND UNDERSTAND THE CONTENTS OF THIS DOCUMENT AND SIGNED THE SAME OF MY OWN FREE WILL.

VOLUNTEER RELEASE & MEDICAL AUTHORIZATION AGREEMENT ASSUMING RISK OF INJURY OR DAMAGE, WAIVER AND RELEASE OF CLAIMS INDEMNITY AGREEMENT, AND AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT.

WHEREAS, I NOT BEING over the age of eighteen (18) years of age and not being an employee of the City of Pocatello, a municipal corporation, (hereinafter referred to as the City of Pocatello), have made a voluntary request to work, without being paid compensation, at the Zoo owned and operated by the City of Pocatello, and

NOW, THEREFORE, in consideration of the permission given to me to work without compensation as a voluntary at the Zoo owned and operated by the City of Pocatello, I do hereby agree:

I HEREBY REPRESENT THAT I HAVE CAREFULLY READ AND UNDERSTAND THE CONTENTS OF THIS DOCUMENT AND SIGNED THE SAME OF MY OWN FREE WILL.

Volunteer Signature

Parent/Guardian Signature

I, the parent/guardian of the above named volunteer, support my child's involvement in the programs and will provide transportation and ensure that my child meets his/her commitment as a youth volunteer at Zoo Idaho.

Age Acknowledgment

I am over the age of eighteen (18)

Signature

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.