TLHS Volunteer Policy, Agreement, and Waiver

Volunteer Application Form 

                                                        Please print clearly 

Today’s Date: __________________Your Birthdate: ______________________ 

Name:________________________________________________________

               (Last)                                (First)                         (Middle I.)                 (Suffix)  

Address: ________________________City: ________________

State: ___________   Zip:_________________ 

Preferred Phone:                                                               

E-mail:__________________________________

Preferred Method of Contact: _____ Text  ______Call  ______ Email 

Emergency Contact Information 

Name: ___________________________________Relationship:__________________Phone:___________________________________

Volunteers wishing to come and physically volunteer at the shelter must be 16 years of age or older to volunteer without a parent or legal guardian.  Are you 16 years old or older? ☐Yes ☐No 

Parent/Guardian Information (if under 16 years of age) 

Name:________________________________ Relationship:__________________________

Phone:_______________________________

Have you volunteered with TLHS before? ☐Yes ☐No  If yes, when? ___________________________

What duties did you perform?_____________________________________________________

__________________________________________________________________________

Do you have any special training or skills that you would like to use at the shelter? ☐Carpentry ☐Animal Health / Behavior ☐Fundraising ☐Customer Service ☐Organizing ☐Computers / IT ☐Data Entry ☐Landscaping ☐Graphic Design ☐Communications/PR ☐Event Planning ☐Grooming ☐Other  

Do you have previous experience working with animals? ☐Yes ☐No 

If Yes, please explain:________________________________________________________

Do you have any physical restrictions, medical limitations or allergies which may require special  accommodations or restrict your volunteer activities? ☐ Yes ☐No 

If yes, please explain: (For example: Can’t lift over 20 pounds, walk large active dogs, etc.)_______________________________________________________________________________________

Volunteer Needs: The following is a list of opportunities. Please check which assignments you  would be interested in: 

☐Socialization (Dogs) 

Dog socializers take dogs to designated areas to make sure dogs are properly socialized and exercised, mainly walking.

☐Socialization (Cats) 

Cat socializers interact and play with the cats. Knowledge of cat behavior is helpful but not required.

☐Clean Team 

Cleaning and helping keep our shelter well-kept, including cleaning kennels, washing windows, doing laundry, poop scooping, etc…..

☐Shelter Ambassador 

The ambassador greets customers and assists them with their needs. The front lobby is the first impression our customers have of our shelter staff. A cheerful attitude and customer service skills are an absolute must!

☐Petco (off-site  

adoption)

Petco team members help the staff load and unload adoptable animals, clean kennels at the store, and/or walk and share information with potential adopters.

☐Organization Team 

This team will help us move and organize things in the shelter. 

☐Yard Work

“Prettying up” the outside of our beautiful facility! Pick weeds, plant flowers, cut the grass, weed-eat, etc…

☐Event Planning &  

Support

Assist with event projects (planning, managing volunteers, designing event activities, etc.)

☐Geek Squad 

Technology work such as creating tools, databases, and/or managing and analyzing data

☐Publicity &  

Communications

Helping to publicize, market, and connect the public with TLHS news,  events, and opportunities

Preferences: (Check all that apply) 

   ☐I prefer to work only with cats. 

☐I prefer to work only with dogs. 

☐I will work with cats or dogs. 

☐I would rather not work with the animals. 

☐I prefer to work only at home. 

☐I do not want onsite at the shelter and prefer to work at off-site activities.

 

Understanding, Agreement & Release 

 

In consideration of being permitted to participate as a volunteer with the Tupelo-Lee Humane Society and in  consideration of the mutual promises of the parties, the Volunteer and/or their parent or guardian makes the  following commitments/agreements: 

1. As a volunteer I understand that my role at TLHS is to assist the staff in caring for homeless and needy animals. I also recognize that the staff and management make all decisions regarding the disposition of animals, up to and including euthanasia. Questions regarding these decisions are to be addressed by the Director of Operations and/or the Executive Director. 

2. As a volunteer I agree to serve without compensation or pay for such periods or periods as mutually agreed upon by the parties. 

3. Volunteers and/or their parents/guardians understand and agree to TLHS’s use of pictures containing volunteers on their website and/or in publications chosen to promote its shelter. 

4. I agree to respect and maintain the confidentiality of all donors, customers, volunteers, staff, and animals of the Tupelo-Lee Humane Society both on and offsite, during and outside of volunteer hours. I understand that any disrespectful or misleading representation of the Tupelo-Lee Humane Society may be cause for immediate dismissal from the Volunteer Program. 

5. Volunteers and/or their parent/guardian assumes full responsibility for all risks of loss or damage or injuries that may be suffered by the Volunteer, his/her spouse, legal representatives, heirs and assigns, or to property owned by the Volunteer or in his/her custody in the course of activities on behalf of TLHS  from any cause, including but not limited to, ordinary negligence attributed to or which might be sustained or suffered at any premises under the control of TLHS or any other premises not under the control of TLHS, or when en route to or from such places or premises. 

6. Volunteer and/or their parents/guardians hereby discharge and indemnifies TLHS and its agents,  directors, officers, employees, and other volunteer workers of and from and in respect to any and all claims, actions, and rights of causes of action, present or future, whether known, anticipated,  unanticipated, on account of any personal injury, including death, or loss of, or damage to any assigns from any cause incident to arising out of, during, or in connection with Volunteer’s performance or Volunteer’s services at the place or places and in the performance or activities as are described in this agreement. 

7. The representations, conditions, and commitments contained in this instrument shall be binding upon the Volunteer’s parents/guardians, heirs, legal representatives, and assigns. 

8. This agreement contains the entire agreement between the parties hereto and the terms are contractual and not a mere recital. 

9. Volunteer and/or the parents/guardians further state that he/she has carefully read the foregoing Release and knows the contents thereof and sign this Release freely and voluntarily. 

10. By signing this document, Volunteers and/or the parents/guardians are stating that all the information given herein is accurate and complete and do hereby give consent for TLHS to verify any and all information contained herein. 

 

By signing below, I understand the risks of spending time in the animal shelter and agree to assume responsibility for any and all injury, harm, or other incidents that may occur during my time volunteering. I agree to follow all of TLHS’s policies and procedures. I also understand that if I exhibit any behaviors considered by TLHS staff to be dangerous or inappropriate, I will be removed from my volunteer duties immediately. 



Rules and Regulations of TLHS 

 

Please initial each blank below that you have read and understand the following rules and regulations of TLHS:

 

Volunteer Guidelines:

 

_______ You are responsible for keeping up with your own hours. We highly recommend you make an account on Better Impact at https://www.betterimpact.com/ You can track your hours here. We can also use this data for future grants. 

 

______Make sure a TLHS staff member knows where you are at all times.

 

______The TLHS telephone should only be used in case of an emergency and only with the permission. You should not be receiving phone calls through our business phone. 

 

______Horesplay, fraternizing, fighting, violence or any other action interfering with your volunteering or the work of a TLHS staff member, another TLHS Volunteer, or a TLHS light/moderate duty worker is prohibited and is grounds for immediate dismissal. 

 

______ Stealing is strictly prohibited and will result in immediate dismissal and the proper authorities will be notified. 

 

______Volunteering or coming into volunteer under the influence of alcohol or any illegal substances is strictly prohibited and is grounds for immediate dismissal. 

 

______Treat everyone will respect. If you see another volunteer, staff member, or light/moderate duty worker being disrespectful in any way, please contact the volunteer coordinator immediately. 

 

______Loafing and/or sleeping while volunteering, or anything that is not productive, is grounds for immediate dismissal. 

 

______TLHS staff and TLHS light-moderate/duty workers are expected to provide a positive, prestable image to our customers and so should our volunteers. Tee shirts and jeans are recommended as some jobs may require you to get dirty. Closed-toed shoes are required. Absolutely no short shorts, jeans with holes, tank tops, shirts with profanity or alcohol are allowed.  

 

______Cell phones are only to be used outside of the shelter or on designated breaks. If you have a cell phone it should be on silent and kept out of sight. 

 

______It is suggested you invest in some earbuds since it can get loud especially if you are working in the large dog runs. I hesitate to say you cannot listen to music because you will see many employees do. They however are used to and aware of their surroundings. Be cautious until you are used to working in the shelter. Stay aware of your surroundings, never turn your back on an animal, and keep a watch on the animal’s behavior. 

 

______Please do not loiter or hang out in front of the shelter or invite your friends to come to see you while you are working. If your friends want to volunteer with you they are more than welcome!

 

______You are not allowed to conceal or carry any type of weapon or any type of illegal or controlled substances or alcohol. 

 

Volunteer  Waiver of Liability:

 

_____I fully understand and agree to assume all risks involved in any and all duties that I perform at TLHS.

 

____I fully understand and agree that either fail to comply with any and all of the obligations outlined in this agreement or for any reason whatsoever, TLHS has sole discretion to immediately dismiss me from volunteering. 

 

_____I fully understand that I am responsible for keeping a signed record of all my hours and job duties performed (especially if you need them for school). 



Volunteer Signature:_________________________________________

 

Volunteer Name (Please print)__________________________________ 

 

Date:___________________________



                                                                                                                                                                                                                       























TLHS.DOC.1001.06 2022-JUN-17 

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