Child Waiver Form

Please complete the form below

Name of parent of legal guardian

First Name

Last Name

Email Address

Phone

Country

(###)

###

####

Child's name

First Name

Last Name

Date of birth

YYYY

I give permission for my child to serve as a Junior or Teen Volunteer at the Columbus Humane Society (CHS). I understand that my child (if under the age of 16 years) must work alongside another qualified CHS volunteer of at least 21 years of age at all times. I give permission for the following adult volunteer partner to serve as my child’s Adult Volunteer Partner (AVP):

Yes

Please check each point

My child will abide by the mission, rules, regulation, policies and programs of CHS while serving as a volunteer.

I understand animals can bite, scratch or otherwise injure my child while he/she is volunteering or on the CHS premises preparing to volunteer or just having completed volunteering and I knowingly assume the risk of injury or sickness and I hold harmless and waive any all of my child’s rights against CHS and its employees, officers, veterinarians, agents, Board of Directors and Executive staff for any injury or sickness, known our unknown, which may develop now or in the future.

I understand that training for new volunteers of CHS includes discussion and information on sensitive topics such as euthanasia, animal abuse and neglect in the context of cruelty investigations, domestic violence, and surgical procedures such as spay and neuter. It is my responsibility to determine the appropriateness of these discussions for my child.

CHS is not liable for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which my child might suffer or sustain in connection with the performance of their volunteer activities for CHS.

I hereby release and indemnify, defend and hold harmless the Columbus Humane Society, its directors, officers, employees, agents, and volunteers and their heirs, successors, assigns personal respresentatives from and against any liability, whatsoever.

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