Transport Volunteer Application

Arkansas Weimaraner Rescue

Individual or Couple *	Individual Couple
Primary First Name *
Primary Last Name *
Secondary First Name *
Secondary Last Name *
Address *
City *
State * AR|AL|AK|AZ|AR|CA|CO|CT|DE|FL|GA|HI|ID|IL|IN|IA|KS|KY|LA|ME|MD|MA|MI|MN|MS|MO|MT|NE|NV|NH|NJ|NM|NY|NC|ND|OH|OK|OR|PA|RI|SC|SD|TN|TX|UT|VT|VA|WA|WV|WI|WY
Zipcode *
Primary Phone *
Primary Email *
Secondary Phone *
Secondary Email
Vehicle(s) Description (Make, Model and Color) *
License Plate(s) *
Emergency Contact: name and phone number *
Description: (Ethnicity, height, eye and hair color *
Can you provide proof of insurance? *	NoYes
How far (in hours) are you willing to travel from pick up to drop off? *
Preferred meeting places - beginning of leg and end of leg *
References: i.e. vet, rescue group, previous transport *
As a volunteer for Arkansas Weimaraner Rescue (AWR), I recognize and acknowledge that certain risks of physical injury, damage, and loss are associated with the volunteer activities I have undertaken and will undertake for AWR. I agree to all risks for, and cost of, any such injuries, damages, or loss which I may sustain as a result of acting and participating as an AWR volunteer. I understand and agree that AWR does not insure against, and accepts no responsibility for personal injury, property loss, or damage which I may sustain. I understand and agree that AWR does not provide financial assisatance to volunteers, including but not limited to, medical, health, or disability insurance. In consideration of AWR allowing me to act as a volunteer and participate in AWR events and for other good and valuable consideration, the receipt of which is hereby acknowledged, I agree and promise for myself, and anyone else who may claim on my behalf, not to sue, and I hereby waive, release, and discharge AWR, its directors, officers, agents, and event officials, and volunteers, from any and all claims and liability of whatever kind or nature whatsoever arising out of my participation in various activities as an AWR volunteer, even tho those claims and liabilities may arise as a result of the negligence or carelessness of individuals released by this waiver & release. You also agree by submitting you will be added to our mass emailing list.
*	By clicking this box you agree to our Terms & Conditions

Please click Submit ONLY ONCE to submit form to Arkansas Weimaraner Rescue. If you do not receive a confirmation email after you hit Submit, please re-submit your application.