Wranglr

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 CHAPS. Make sure you have access to both the email account and the mobile for texts.

First Name *

Last Name *

Email *

Mobile *

Photo & Publicity Release

Consent to and authorize the use and reproduction by CHAPS Equine Assisted Services of any and all photographs and any other audio-visual materials taken of me/my child/my ward for promotional material, educational activities, and exhibitions or for any other use for the benefit of the program.

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

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

I understand that in order to remain a volunteer at CHAPS Equine Assisted Services, I will be asked to follow the rules and guidelines of the organization. I have been given a copy of these rules and guidelines and will follow them.

I accept the release of liability *

Confidentiality

As a participant at CHAPS, I agree to hold in strict confidence those names, all medical, social, referral, personnel and financial information regarding clients, staff, volunteers or any and all participants at CHAPS Equine Assisted Services at any time and in any capacity. I agree to the above stipulations regarding confidentiality, and furthermore understand that violating this agreement in any way may result in the termination of my association with CHAPS, and possible legal action.

I accept the confidentiality release *

Consent to Electronic Signature

I understand that by accepting the general liability and confidentiality forms, it is the same as signing the document and acts as my electronic signature.

I consent to Electronic Signature *

CHAPS Volunteer Application