| Name: ____________________________________________________________________ | ||||||||||||||||||||||||||||||||
| Address: __________________________________________________________________ | ||||||||||||||||||||||||||||||||
| __________________________________________________________________________ | ||||||||||||||||||||||||||||||||
| Phone number: Home: _________________________ Office: _______________________ | ||||||||||||||||||||||||||||||||
| When is the best time to reach you? ____________________________________________ | ||||||||||||||||||||||||||||||||
| Emergency contact: | ||||||||||||||||||||||||||||||||
| Name/Relationship: __________________________________________________________ | ||||||||||||||||||||||||||||||||
| Phone number: Home: _________________________ Office: ________________________ | ||||||||||||||||||||||||||||||||
| E-mail address: _________________________________ Birthdate: _________________ | ||||||||||||||||||||||||||||||||
| Do you have previous experience with horses and ponies? Please specify. | ||||||||||||||||||||||||||||||||
| __________________________________________________________________________ | ||||||||||||||||||||||||||||||||
| __________________________________________________________________________ | ||||||||||||||||||||||||||||||||
| List any other skills or training you have which may be of benefit to our program: | ||||||||||||||||||||||||||||||||
| ___________________________________________________________________________ | ||||||||||||||||||||||||||||||||
| ___________________________________________________________________________ | ||||||||||||||||||||||||||||||||
| Please check the area(s) which most interest you: | ||||||||||||||||||||||||||||||||
| ____Sidewalker/leader during lessons | ____Publicity | ____Equipment care | ||||||||||||||||||||||||||||||
| ____Office/administrative | ____Fundraising | ____Other_________________ | ||||||||||||||||||||||||||||||
| Please indicate the lesson(s) you are able to
assist with as a regular (weekly) volunteer: |
||||||||||||||||||||||||||||||||
| Lessons last one (1) hour for all our riders. | ||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
By signing below, I agree to indemnify, defend, and hold harmless Hope Springs
Equestrian Therapy,
Inc. and Green Lane Farm, and their respective employees, agents, and representatives,
from and
against all claims, demands, causes of action, losses, costs, and expenses (including
reasonable
attorneys' fees) (collectively, "Losses") arising in favor of any
person on account of or as a result of
my negligence or willful misconduct, or bodily injury and property damage resulting
from or incident
to my involvement with Hope Springs Equestrian Therapy, Inc.
| _______________________________________ | _________________________ |
| Volunteer's Signature | Date Signed |
| _______________________________________ | _________________________ |
| Parent or Guardian's Signature | Date Signed |
Please return volunteer sign-up sheet to:
Hope Springs Equestrian Therapy
P.O. Box 156, Chester Springs, PA 19425
(610) 469-6220
www.hope-springs.org