Transport Volunteer Application – Kentucky Mutts Animal Rescue

Become a transport volunteer!

Name

First Last

I like to be called (Nickname)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

I would like to help by being a:

Driver

Overnight Host

Transport Monitor

Other

Driver's License Number

Driver's License State

Expiration

Color, Make, Model of Car I will be driving (Drivers only):

Emergency Contact: (Will be used only in the case of an emergency, such as a medical event or a traffic accident.)

Name

First Last

Relationship

Phone

Please carefully review the following information, and sign below to indicate your agreement: I understand that volunteer activities with Kentucky Mutts Animal Rescue (KMAR) may be hazardous, and may include, but not limited to: handling frightened animals, cleaning feces, urine and vomit, bites and/or scratches, moving crates, bending, stooping, lifting, walking dogs and transporting animals. I hereby expressly and specifically assume the risk of injury or harm in the activities, and release KMAR from all liability of injury, illness, death or property damage or loss resulting from the activities directly or indirectly, and shall forever hold harmless and indemnify KMAR from the same. I do hereby release and forever discharge, hold harmless and indemnify KMAR and its successors and assigns from any and all liability, claims, suits and demands of whatever kind of nature, either in law or in equity, which arise or may hereinafter arise from my activities with KMAR. I hereby certify that I have never been convicted of the following offenses, or similar offenses, as defined by the laws of my state: Animal Cruelty, Neglect, or Endangerment; Driving While Intoxicated, Reckless Driving, or Vehicular Homicide. Statement regarding COVID-19: KMAR has asked all of its volunteers to observe appropriate safety protocols relative to COVID-19. However KMAR cannot guarantee that all volunteers will alway

Comments

Name

First Last

Date

Main location: Corbin, KY
Volunteers transport each week to Minnesota

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