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Shining Stars Volunteer Application

As a Volunteer, you’ll gain tremendous satisfaction from assisting the participants in their progress as they enjoy physical, emotional, and cognitive contact with the horses. Horse experience is not necessary. If you are interested in helping with our riding session, you are invited to come to one training each year. There are so many ways to volunteer outside of classes. Individuals, groups, companies or families can volunteer for one day projects or on a regular basis. Help in the barn, with property maintenance such as mowing, special events or join our fundraising team. IMPORTANT: Please do not list any medications unless it would be important for us to know in an emergency. You also do not need to list insurance information.

Basic Info

First, let's get your basic info. We use Wranglr for helping to schedule our volunteers. Please enter your name, email and mobile number. This info will be used to communicate openings, your schedule and important info from Shining Stars. Make sure you have access to both the email account and the mobile for texts.

First Name *

Last Name *

Email *

Mobile *

Photo & Publicity Release

Photograph, Testimonial and Interview Release In exchange for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I hereby grant to Shining Stars Therapeutic Riding Program inc. (hereinafter referred to as SSTR), its legal representatives, successors and assigns, and those acting with their authority and permission (collectively, “SSTR”) the right and permission to use, re-use, publish, re-publish, and copyright (in SSTR’s own name and otherwise) testimonials (written by me or attributed to me), interviews (written by me or attributed to me), and photographic portraits, pictures, images and/or likenesses of me or in which I may be included (in whole or in part, or composite, or distorted in character or form, without restriction as to changes or alterations), in conjunction with my own or a fictitious name, made through any medium, and in any and all media now or hereafter known throughout the world in perpetuity. All rights, licenses and privileges herein granted to SSTR are irrevocable and not subject to rescission, restraint or injunction under any circumstances. I hereby waive any right that I may have to inspect or approve the finished product, or products and the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied. I hereby release, discharge and agree to save harmless SSTR from and against any claims, damages or liability arising from or related to the use of any of the aforementioned material, including but not limited to any liability by virtue of any editing, blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking, recording, editing, processing, publishing or distribution of said testimonials, interviews, pictures, portraits, images and/or likenesses including, without limitation, any claims for defamation, invasion of privacy, right of publicity or violation of any other right. I hereby acknowledge that the compensation provided does not include any monetary compensation or tangible goods or services and that none are due to me for granting this release. I hereby warrant that I am of full age and have the right to contract in my own name. I have read this Release prior to its execution, and I am fully familiar with the contents thereof. This Release shall be binding upon me and my heirs, legal representatives, and assigns. If signing as parent or guardian, I herby warrant and represent I am the parent or legal guardian of the named minor and have authority to and do hereby consent to this Release on his/her behalf and will be responsible for any damages incurred by SSTR resulting from the minor’s breach or renunciation of this Release.

YES - I CONSENT to photos/publicity release

NO - I DO NOT CONSENT to photos/publicity release

Additional Info

Why do we need this info? Some volunteering roles and duties might require you to work with larger horses, carry heavier things, etc. We also work with Participants that have many different needs and the below information helps us make more informed decisions for our Participants and Volunteers. Please fill out whatever info you are comfortable sharing with us.

Height

Weight

Gender Identity

Please Share Your Pronouns (optional)

T-Shirt Size

Driver's License (State and # please)

Birth Date*

Parent/Guardian/Caregiver Info

If you are a minor or an adult with legal guardians/caregivers, or are filling out this application on behalf of someone else, please include Parent or Guardian/Caregiver info below.

Parent or Guardian/Caregiver Name

Parent or Guardian/Caregiver Phone

Parent or Guardian/Caregiver Email

Contact Info

Street Address *

Additional Address Info

City *

State *

Postal code *

Country *

Emergency Contact

Emergency Contact Name *

Emergency Contact Relation *

Emergency Contact Phone *

Experience and Health Info

Do you have any previous horse experience? *

Have you had any previous experience working with people with special needs? *

Have you ever been convicted of a crime?

If so, please explain below

Enter your School or Employer name *

Pre-existing Health Conditions (put n/a if none) *

Please list all medication you are taking (including medical marijuana) (put n/a if none) *

Please note any allergies and if EpiPen or inhaler is used (put n/a if none) *

What is your general health status? Tell us about any special needs or health concerns *

Do you have Health Insurance?

Insurance Details - please put company and coverage dates

Important Information and Acceptances

General Liability Release

EQUINE ACTIVITY LIABILITY RELEASE, WAIVER OF RIGHT TO SUE AND ASSUMPTION OF ALL RISKS THIS Equine Activity Liability Release, Waiver of Right to Sue and Assumption of All Risks Agreement (hereinafter referred to as "Agreement'') is hereby given by the undersigned to Shining Stars Therapeutic Riding Program Inc. (hereinafter referred to as "Sponsor'')"and to each officer, agent, employee, director, member, heir, personal representative, successor and assign of the Sponsor, and provides as follows: In consideration for the opportunities provided by the Sponsor to the undersigned (including any minor in whose behalf the undersigned signs this Agreement) (hereinafter referred to as the "Participant'') for the enjoyment of equine activities as participant, the participant, including any minor participant for whom he signs this Agreement, hereby agrees as follows: 1. This Agreement is given in part under the Equine Activity Liability Act, 4 P.S. §601, et. seq., as it may now provide or be hereafter amended, (hereinafter referred to as the "Act''). All terms defined by the Act shall have the same meaning herein, and the Act is hereby incorporated in this Agreement by reference: This Agreement shall be so construed as to provide to the Sponsor the fullest protection of the release, waiver of right to sue and assumption of all risks that is afforded by the Act, by other applicable statues and by general law. 2. The Participant hereby acknowledges that he has full and complete notice and understanding of the Act and of all the risks inherent in equine activities which may cause, contribute to or result in the death of personal injury of the participant or damage to the participant's property (the ''Risks"). These risks include, but are not limited to: (i) the propensity of equines to behave in ways that may result in injury, harm, or death to persons on or around them; (ii) the unpredictability of an equine's reactions to such things as sounds, sudden movement, and unfamiliar objects, persons or other animals; (iii) certain hazards such as surface and subsurface conditions; (iv) collisions with other animals or objects; (v) the potential of a participant acting in a negligent manner that my contribute to injury to the Participant or others, such as failing to maintain control over the equine or not acting within the Participant's ability; (vi) the propensity of an equine to behave in dangerous ways or to trip and/or fall; (vii) the inability of anyone whomsoever to predict or foresee an equine's reaction to excitement, weather conditions, sound, movements, objects, vehicles, persons, animals, reptile, birds or insects, and the effects of such reactions; (viii) the hazards of surface or subsurface conditions, including but not limited to objects or conditions on, under or protruding from the surface both latent and patent; (ix) the hazards which rocks, cliffs, hills, fences, trees, stumps, logs, bridges, ditches, bodies of water, debris and obstacles, and any equine activity; (xii) the risks of falling from or otherwise becoming unstable on an equine or a vehicle used in an equine activity for any reason whatsoever or for no identifiable reason; (xiii) the dangers of being struck by an equine, or by rider; (xiv) any negligent act or omission by the Sponsor or any owner which causes or results in the death or personal injury of the Participant or damage to the Participant's property; and (xv) all other risks associated horseback riding [handling horses], and related activities. 3. The Participant hereby RELEASES and WAIVES all rights which he may have or hereafter have against the Sponsor for injury, loss, damage or death which is in any way resulting from the intrinsic dangers of equine activities and/or associated with the Risks enumerated in Paragraph 2 above; Participant does hereby WA.IVE his or her right to sue or to bring any action against the Sponsor in connection therewith; Participant agrees to INDEMNIFY and DEFEND the Sponsor from and-to HOLD the Sponsor HARMLESS against any such Suit or action, including reimbursement of legal fees associated with the defense of any claim; and he hereby expressly ASSUMES ALL RISKS AND DANGERS of injury, loss, damage or death which are in any way resulting from the intrinsic dangers of equine activities and/or associated with the Risks enumerated in Paragraph 2 above, including omission that constitutes negligence for the safety of the Participant by the Sponsor, any owner or any other person. 4. The Participant hereby authorizes and consents to any emergency medical care which may, at the time, appear reasonably appropriate under the circumstances as a result of injury or sickness caused by or incurred in the course of an equine activity. 5. This Agreement shall remain valid and in full force and effect from and after the date opposite the signature of the Participant until expressly revoked by the Participant in a written notice personally delivered to the Sponsor. 6. To the extent possible, this Agreement shall be construed in such manner as will render it, and each provision of it, fully enforceable; but if any provision of this Agreement shall be unenforceable, such provision (or so much thereof as is unenforceable) shall be deleted and the remainder of this Agreement shall continue in full force and effect. 7. If this Agreement is executed by the undersigned for and on behalf of a minor Participant named below, the undersigned hereby warrants and represents that he is in fact the legal parent or guardian of such minor, with full rights of custody and control; that this Agreement is given on behalf of and is intended to be binding upon said minor participant, his heirs, personal representatives, successors and assigns; and the undersigned further agrees that this Agreement shall also be as fully binding on the undersigned as if it were entered into solely on his own behalf. 8. This Agreement shall be binding upon the heirs, personal representatives, successors and assigns of the Participant and the undersigned, I HAVE FULLY READ AND FULLY UNDERSTAND THE FOREGOING EQUINE LIABILITY RELEASE, WAIVER OF RIGHT TO SUE AND ASSUMPTION OF ALL RISKS. I HAVE CONSULTED AND RELIED UPON MY OWN ADVISORS ON ALL QUESTIONS IN CONNECTION THEREWITH, AND I HAVE NOT RELIED UPON THE SPONSOR/PROFESSIONAL, ANY OWNER OR THE EQUINE ACTIVITY SPONSOR FOR ANY ADVICE OR EXPLANATION IN CONNECTION THEREWITH.

I accept the release of liability *

Background Check Release

At Shining Stars, we require a Background Check for our Volunteers.

I hereby grant Shining Stars permission to run a background check *

All Volunteers will need to complete a criminal record check and child abuse clearances. Step 3 – To complete the criminal record check, (will add link soon. Step 4 – To complete the PA Child Abuse Clearance click here- https://www.compass.state.pa.us/cwis/public/home You do not need to have these completed to attend a training.

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