Volunteer Application - Teen/Jr

Thank you for your interest in joining the Volunteer Program at the Jefferson County Animal Shelter, under the direction and supervision of the Jefferson County Humane Society (JCHS). At this time, we ask for a six-month commitment and a minimum of either 2 hours per week or 8 hours per month.

Please note that the completion of this application does not constitute immediate acceptance into the volunteer program. Applicant must complete the volunteer orientation program prior to providing volunteer time at the shelter or off-site events.

Teen/Jr Volunteer Application
Must have parent/guardian consent

What is your area of interest? Please check all that apply:

Past Experience or Training

Please answer the following so that we may match your experiences and training to our Volunteer Program.

Teen/Jr Volunteer Agreement, Waiver and Release of Liability

Parent/Guardian - Please read and accept along with your minor child:

I have been offered the opportunity to act as a volunteer for the Jefferson County Humane Society, a nonprofit Ohio charitable corporation serving Jefferson County, Ohio. I want to participate in Humane Society programs as a volunteer because it gives me pleasure and satisfaction to be personally involved in animal rescue. I fully understand the risks associated with handing and being in the vicinity of animals, particularly animals which may be ill, injured, neglected or abused, and I voluntarily assume those risks.

In exchange for the privilege and license to enter and use Jefferson County Shelter facilities, and interaction with the Jefferson County Animal Shelter animals on or off shelter premises, I do hereby release and forever hold harmless the County of Jefferson, its Board of Directors, the Jefferson County Humane Society, and their officers, agents, employees, representatives, successors and assigns (collectively herein County and JCHS) from and against any and all claims for injury, disability, or death sustained by me or for damage to my property, and from any other claims, demands, liability, judgments, awards, costs and expenses of whatsoever kind and nature, which may arise from or during my use of shelter facilities, and interaction with shelter animals on or off shelter premises. I agree to indemnify, defend and hold harmless the County and JCHS from and against any and all liability whatsoever arising out of or related to my negligent performance of duties under this agreement.

I will complete and follow any training required for the volunteer program.

I will treat all animals and other volunteers with respect and I will work as a team member with all volunteers. I hereby certify that I have never been convicted of animal cruelty, neglect, or abandonment.

I will abide by all JCHS policies and procedures and follow the directions/instructions of the JCHS Staff, Volunteer Coordinator and Animal Officers.

I will make no public statements or contracts. I have no authority to make public statement on the Humane Society’s behalf, adopt out animals except in compliance with Humane Society’s procedures, enter into contracts for Humane Society, or otherwise obligate Humane Society in any way.

I will keep Humane Society information confidential. I will not disclose, or authorize or permit anyone else to disclose any information relating to the operation of the Humane Society, or its business or financial condition, including but not limited to its policies, practices, financial records, business records, donor lists, personnel documents, minutes, books, recordings, photographs, videos, computer data or information, or copies of any of the foregoing. Such information is referred to as “Confidential Information.” This restriction shall apply even after I am no longer acting as a volunteer for the Humane Society for any reason. I will not remove confidential information from Humane Society premises without prior authorization.

Volunteers can be terminated. The Humane Society may terminate my volunteer activities at any time, with or without cause. Upon termination, or upon my voluntary resignation, I will immediately return all animals, equipment, records and other property owned by Humane Society. I will not keep any information relating to Humane Society on my computer or any other electronic storage device. Such information shall be deleted or otherwise destroyed immediately after I cease being a volunteer for the Humane Society.

Reimbursement policy - I will only be entitled to reimbursement for out-of-pocket expenses when I have previous written permission from the Humane Society Board, and can provide receipts as proof for each expenditure. Otherwise, I will be personally responsible for any expenditure I make while volunteering for the Humane Society. Anything I purchase and any service I arrange or provide for the Humane Society shall be considered a donation to the organization.

Publicity - I support the Humane Society’s mission, therefore I irrevocably grant permission to the Humane Society to use any photograph, video, sound recordings or quote taken of or made by me relating to my volunteer activities with Humane Society without compensation.

I agree to follow the guidance and or directions of the JCHS personnel, Dog Warden, Volunteer Coordinator or JCHS Board Member. Should any problems arise, I will report it promptly to a JCHS Staff Member or the Volunteer Coordinator.

I understand my privilege to enter and use the facilities carries certain risks, such as personal injury, property damage, disability or death and I hereby assume fully all risks from my use of said facilities as a volunteer.

I understand the possible risk of bringing home illnesses from the shelter to personal pets or vice versa and must have current vaccinations for animals at home.

I understand the potential safety risks of working with animals and that I may not bring friends or relatives with me while volunteering at the shelter facility unless they have taken the Volunteer Program Orientation.

I acknowledge that my use of the facilities is for my own benefit, is voluntary, and is personal, and is not assignable to or intended to support any group for any reason except JCHS.

My use of the facilities is not within the scope of any employment relationship between the County/JCHS and myself. I will not be compensated in any form for my time spent at the facilities or my efforts expended within the facilities; nor will I be covered by the County/JCHS workers compensation program should I be injured.

I understand that JCHS relies on me to be present for all of my scheduled shifts. In addition, I will also provide advance notice to the Volunteer Coordinator of any such shift changes.

I authorize JCHS to seek emergency medical treatment for me in case of accident, injury, or illness. I understand and acknowledge that it is my responsibility not to exceed any guidelines that my physician or other health care provider has established or may establish for me. It is solely my responsibility to determine what my physical limitations are or may be and that I should disclose these limitations on my volunteer application.

I warrant that as of the date of this signing that I currently have sufficient health, disability and life insurance as determined by me or my advisors to cover me. Moreover, I fully assume any and all risk for any lapse in or insufficiency of coverage in said health, disability, and life insurance in the event of my injury, disability, damage or death resulting from the use of the facilities.

If I fail to abide by the terms of this Agreement or am otherwise unable to meet the requirements of the volunteer program, which are subject to change by JCHS from time to time, I understand that I will be terminated from the program. I also understand that I may at any time be removed from my position as a volunteer at the sole discretion of the Shelter Manager and/or the Volunteer Coordinator or the Board of Directors.

Tetanus Information: I understand that because I may handle animals, it is important to discuss the tetanus vaccine with my physician. I release JCHS from all responsibility that may occur because of my not pursuing this matter further and I understand whatever decision I make is at my own risk.

I certify that the information provided here is accurate and complete. I authorize reference verification as necessary for specific positions.

I acknowledge that my status with the JCHS is classified as volunteer and I am not an employee of JCHS or Jefferson County. I am ineligible for Workers Compensation coverage if injured while volunteering. I understand that I will not be compensated monetarily for the work I do while volunteering with the Jefferson County Humane Society. I agree that, for any accident or injury that I may be a party to or witness, I will make a report to the Shelter Manager, Volunteer Coordinator or a Board Member immediately so an accident or injury report can be completed.

Remedies - Humane Society may bring an action at law or in equity in court of competent jurisdiction to enforce the terms of this agreement, to enjoin the violation, ex parte as necessary, by temporary or permanent injunction, to recover any damages to which it may be entitled for violation of the terms of this agreement. Humane Society’s rights under this paragraph apply equally in the event of either actual or threatened violations of the terms of this Agreement. I agree that Humane Society’s remedies at law for any violation of the terms of this agreement are inadequate and that Humane Society shall be entitled to the injunction relief described in this paragraph, both prohibitive and mandatory, in addition to such other relief to which Humane Society may be entitled, including specific performance, without the necessity of proving either actual damages or the inadequacy of otherwise available legal remedies. Humane Society’s remedies described in this paragraph shall be cumulative and shall be in addition to all remedies now and hereafter existing at law or in equity.

This Agreement constitutes the entire understanding between the parties. This Agreement shall be construed according to Ohio law. This Agreement may not be amended or modified without a writing signed by both parties.

Parent/Guardian Agreement and Release of Liability

Please read and accept below:

I certify that I am able to sign this Agreement and Release of Liability as the parent or legal guardian of and responsible party for the minor applicant and volunteer. I understand that I am required to volunteer with the minor volunteer age 13 through 15 for whom I am responsible, and that I am to remain with the minor volunteer AT ALL TIMES during volunteer service. I understand that AT ALL TIMES I am responsible for any and all actions or omissions of the minor volunteer, and I assume all responsibility and liability for any and all consequences resulting from those actions or omissions.

I agree to abide by and to ensure that the minor applicant and volunteer will also abide by all the aforementioned rules and regulations.

Upon submitting your Teen/Jr Volunteer Application you will be redirected to our Event's Page to sign up for an upcoming Volunteer Orientation Class. You must complete the Volunteer Orientation Class in order to become an approved JCHS Volunteer. Please note: If you are under the age of 18 you must attend the Volunteer Orientation Class with a parent/legal guardian. Your parent/legal guardian must complete an Adult Volunteer Application. Thank you!