EQUINE PROGRAM SUMMER VOLUNTEER APPLICATION VOLUNTEER NAME: BIRTH DATE: / / MAILING ADDRESS: CITY: STATE: ZIP: CELL PHONE: HOME PHONE: EMIAL ADDRESS: T-SHIRT SIZE (circle one): SMALL MEDIUM LARGE X-LARGE XX-LARGE ALLERGIES: MEDICATIONS: OTHER MEDICAL CONDITIONS: EMERGENCY CONTACT NAME: RELATIONSHIP: WORK PHONE: CELL PHONE: HOME PHONE: PLEASE PROVIDE THE FOLLOWING INFORMATION FOR VOLUNTEERS UNDER THE AGE OF 18: PARENT/GUARDIAN NAME: CELL PHONE: WORK PHONE: EMIAL ADDRESS: Page 1 of 5
EQUINE PROGRAM SUMMER VOLUNTEER REGISTRATION (continued) Please mark any Volunteer Opportunities you are interested in: Jr. Volunteers are currently in middle and high school. They assist with horse care and barn work. For liability reasons, Jr. Volunteers are not permitted to work in the classes and camps until they have graduated from high school. Sr. Volunteers have graduated from high school. Sr. Volunteers who have been with Asbury Equine for an extended amount of time and have shown high levels of commitment to our students, campers, and program may be responsible for assisting in the supervision of other volunteers and horse activities. Special Event Volunteers are current Jr. and Sr. Volunteers. They assist with the coordination, set-up and clean up of any special events. Volunteer Reminders: (if accepted into our volunteer program) Make sure you have filled out all required volunteer application forms before submitting your volunteer packet. All forms require a parent or legal guardian signature. Volunteers are asked to help in many ways. Please speak up if you are asked to do anything you do not know how to do or are uncomfortable with. Please dress appropriately for the weather. A hat, sunglasses and sunscreen is advisable, as well as clothing for rainy weather. Water bottles are advisable especially in the summer months. Please understand that all of the horses are the responsibility of Asbury University Equine. Asbury will make decisions regarding feeding, medical care, exercise and suitability for the program. Jr. Volunteers are only allowed to volunteer during morning shifts: Monday-Friday 8:30am to 11:30am. Jr. Volunteers are required to have supervision when working with and handling horses. Any Jr. Volunteer who shows extreme competence and independence in their daily responsibilities may be asked to volunteer during special events. Page 2 of 5
EQUINE PROGRAM SUMMER VOLUNTEER MEDICAL RELEASE In the even a medical emergency should occur, the Director and staff will make every effort to contact parents in order to approve hospital emergency room care. In the event we are unable to do so, we ask that you sign this release for emergency room treatment. I acknowledge that I (my child), (print name) has come to seeking treatment. (preferred hospital) I hereby authorize the physicians in attendance to employ emergency treatment as they deem necessary upon the above-named person. I also authorize the release of information for the purpose of payment to the hospital and the treating physicians. Printed Name of Authorized Signer Authorized Signature Date INSURANCE COMPANY: ADDRESS: CITY: STATE: ZIP: TELEPHONE: POLICY #: GROUP #: POLICY HOLDER NAME: Page 3 of 5
EQUINE PROGRAM SUMMER VOLUNTEER AGREEMENT We are pleased to have you considering volunteering with us! In return, we ask for your cooperation by agreeing to the following policies: Asbury Equine Volunteers may assist in a variety of different areas that include, but are not limited to: horse care, facility maintenance, and special events. We realize that there are as many ways to do things in the horse world, as there are people who love horses. For this reason, Asbury Equine s procedures must be followed closely. These procedures were created to ensure everyone at Asbury remains safe and happy! Remember SAFETY ALWAYS COMES FIRST!!!! Volunteers must sign in when they arrive and sign out before they leave. Be polite, courteous, and respectful of others. Endless patience and compassion are required when working with people and horses. Dress appropriately for the work you will be doing, always considering the weather. Wear sturdy shoes or boots. NO open-toed shoes or tank tops. Long pants are required. Jr. Volunteers are only allowed to volunteer during morning shifts: Monday - Thursday 8:30-11:30am. All volunteers are invited to stay for a volunteer activity on Friday from 1-2pm. If you do not understand a procedure, ASK QUESTIONS! Any actions or words that could cause harm to you, the horses, or others are unacceptable. Asbury Equine reserves the right to turn away volunteers who are unwilling to participate in the daily barn responsibilities. I have read and understand the above policies of the Asbury University Equine Program and understand that if accepted into the program, I may be asked not to return if I do not abide by them. Volunteer Signature Date Parent/Guardian (if volunteer is under 18) Page 4 of 5
EQUINE PROGRAM RELEASE OF LIABILITY AGREEMENT The student, rider or guardian must sign this form before permission will be given to participate in activity. This release form must be presented to the Equine Director or staff. I recognize there are risks, including those of injury and even death, in all of the activities initiated and carried out under the auspices of the Equine Program. I freely assume those risks on my own. I agree to release and hold harmless from liability the Asbury University Equine Program, its staff, volunteer workers, and other employees and agents in the event of injury or death of my self or dependent, resulting from negligence or any other theory of liability while engaging in any Equine Program activity. I agree to not make any claim or file any lawsuit against Asbury University or the Equine Program for injuries or damages related to my, or my dependent s, participation in any activity. (Please initial ) I understand that this is a legally binding contract and that the Equine Program activities are provided in consideration for this signed Release of Liability Agreement. (Please initial ) I have carefully read this release of liability and fully understand its contents. I am aware that this releases Asbury University and Asbury University Equine Program from liability and I sign it of my own free will. Printed Name Signature Signature of Legal Adult or Guardian (if under 18) Effective date: Please Return This Completed Form To: Asbury University Equine Department Attn: Marilyn Walker 1 Macklem Drive Wilmore, KY 40390 Address questions to: Marilyn Walker marilyn.walker@asbury.edu or (859) 858-3511 x2262 or (859) 317-3782 Page 5 of 5