Volunteer Acknowledgment Form

As a volunteer with the Humane Society of Barron County, I realize the Humane Society does occasionally come into contact with animals that may be rabid or diseased. Instances of bites or other transfers of disease from animals to humans are rare; however they are possible.

While the Humane Society of Barron County may take precautions to insulate its volunteers from exposure to injury or disease, all volunteers are advised by the Humane Society to seek anti-rabies and anti-tetanus treatment from their own private physicians. The decision to seek such treatment is entirely within the discretion of the volunteer and need not be reported or disclosed to the Humane Society. In addition, should such treatment be requested and administered, any and all expenses incurred are the sole responsibility of the volunteer.

If there are any medical conditions that we should be aware of at the Shelter, please describe below:

My signature indicates that I understand that in handling animals for the Humane Society of Barron County Inc, in a volunteer capacity there exists a risk of injury or sickness, including personal injury or harm. On behalf of myself, my heirs, personal representatives and executors, I hereby release, discharge, indemnify and hold harmless HSBC Inc, its agents, officers and directors from any and all claims, causes of actions or demands, of any nature or cause connected with my Volunteer Agreement. This might include connection with my volunteer services based on damages that may be incurred or sustained by me in any way. Such damages might include, but are not limited to animal bites, accidents, injuries and personal property damage.

I, as a volunteer, have read the foregoing and do understand its contents.