Southern Valley Ranch and Rescue
Volunteer Form
4764 River Road, Fort Valley Ga, 31030
850-896-859
georgiahorserescue.co
VOLUNTEER APPLICATION
Please Print
Name: ________________________________________
Phone: _________________________________________
Address:_______________________________________
E Mail: _______________________________________
Street.
Apt #
_______________________________________
Cell: __________________________________________
City
State
Zip
______________________________________________________
Occupation: ___________________________________
Work Phone: ____________________________________
What skills do you wish to offer SVR&R?
___EQUINE
___FARM
TECHNICIAN *
MAINTENANCE
___ HORSEMANSHIP *
___ OFFICE
___ HORSE HANDLING
___ RECEPTIONIST
___ FEEDING & BARN
CHORES
___ FUND RAISING
___ EDUCATION
___ PUBLIC SPEAKING
___ PUBLIC
RELATIONS
ADDITIONAL:
_____________________________________________________________________________________
_____________________________
What can you offer SVR&R to help the horses?
____________________________________________________________________________________
____________________________________________________________________________________
Why do you want to volunteer?
____________________________________________________________________________
What do you expect to get out of SVR&R?
_______________________________________________________________
_____________________________________________________________________________________
_________________
Available Days:_______________________________________
Times: ____________________________________________
Emergency Contact: _____________________________________________________________
Phone: ___________________________________________
Special conditions/limitations/medications to be aware of? (e.x. Asthma, Bee allergies, Heart Conditions,
etc.)_________________________________________________________________________________
__________________________________________________________________________
Tetanus Vaccine (required) _____ Yes. Date: _________________
Additional vaccines relevant to Animal work? ___________________________________
This stable does NOT guarantee your safety.
Please read the equine activity contract, rules, and release of liability very carefully before signing it.
I agree to the following rules and have read and understand the WARNING - Nature of the Horse,
Donkey, Pony, or Mule and will follow them to the best of my ability.
Please remember SVR&R is a business and the animals are why we exist. Our Board of Directors takes
very serious their responsibility to run the organization. SVR&R values all of our volunteers and
appreciates the work that you can offer to further our mission to help neglected and abused horses and
companion animals. Thanks again for your desire to help!
"SVR&R reserves the right to dismiss any volunteer at any time for misconduct or failure to
adhere to SVR&R Rules and Regulations. Misconduct includes actions that we feel may
present a danger to yourself, other volunteers or the animals"
“WARNING:Under Georgia law, an equine activity sponsor or equine professional is not liable for an
injury to or the death of a participant in equine activities resulting from the inherent risks of equine
activities, pursuant to Chapter 12 of Title 4 of the Official Code of Georgia Annotated.
I ________________________________________________ certify the above information is true and
accurate to the best of my knowledge, and that any misleading or false information contained in this
application will lead to my dismissal.
Signature: _______________________________________________________
Date: ____________________________________________________________
You Must also sign the SVR&R Participation Agreement BEFORE participation in any SVR&R activities.
NOTES FOR OFFICE USE ONLY:
All information contained herein and above is in strict confidence and for private organizational use only.
SVR&R PARTICIPANT AGREEMENT, RELEASE, AND ACKNOWLEDGEMENT OF RISK
1. I acknowledge that any horse or farm/animal or dog related activity entails known and
unanticipated risks which could result in physical or emotional injury, paralysis, death, or
damage to me, to property, or to third parties. I understand that such risks simply cannot be
eliminated without jeopardizing the essential qualities of the activity.
The risks Include, among other things: The propensity of equines/canines et al. to behave in
ways that may result in injury, harm, or death to persons on or around them irrespective of their
previous behavior and characteristics; the unpredictably of an equine/canine's reaction to such
things as sounds, sudden movement, and unfamiliar objects, persons, or other animals, or
more: certain hazards such as surface and subsurface conditions; collisions with other
equines/animals or objects; failing to maintain control over the animal; being bounced, jostled, or
thrown due to passage over varied, sometimes rough terrain; the risk of falling off or being
thrown from a horse could occur resulting in injuries even death; adverse weather could result in
my being exposed to cold, wind, rain, and/or snow, and could cause a loss of control over the
horse/canine; latent or apparent defects or conditions in equipment, animals or property: contact
with plants or animals; my own physical condition or my own acts or omissions; first- aid,
emergency treatment or other services rendered; consumption of food or drink.
Furthermore, SVR&R has difficult jobs to perform. They seek safety, but they are not infallible.
They might be ignorant or uninformed of a participant's fitness or abilities. They might misjudge
the weather, the elements, or the terrain. They may give inadequate warnings or instructions,
and the equipment being used might malfunction.
2. I expressly agree and promise to accept and assume all of the risks existing in this activity.
My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless
SVR&R from any and all claims, demands, or causes of action, which are in any way connected
with my participation in this activity or my use of SVR&R’s equipment or facilities, including any
such Claims which allege negligent acts or omissions of SVR&R.
4. Should SVR&R or anyone acting on their behalf, be required to incur attorney's fees and
costs to enforce this agreement, I agree to indemnify and hold them harmless to such fees and
costs.
5. I certify that I have adequate insurance to covet any injury or damage I may cause or suffer
while participating, or else I agree to bear the costs of such injury or damage myself. I further
certify that I have no medical or physical conditions, which could interfere with my safety in this
activity, or else I am willing to assume and bear the costs of all risks that may be created,
directly or indirectly, by any such condition.
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my
participation in this activity, I may be found by a court of law to have waived my right to maintain
a lawsuit against SVR&R on the basis of any claim from which I have released them herein. I
have had sufficient opportunity to read this entire document. I have read and understood it, and I
agree to be bound by its terms.
WARNING: NATURE OF THE HORSE, DONKEY, PONY, OR MULE
Riding, leading and handling horses, donkeys, ponies or mules (equines) are classified as rugged
adventure recreational sport activities. There are numerous obvious and non-obvious inherent risks
always present in such activities - despite all the safety precautions. No equine is a completely safe
animal. Equines are 5 to 15 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a
human is. If a rider falls from an equine to the ground, it will generally be a distance of from 3.5 to 5.5
feet, and the impact may result in injury to the rider. Equine riding is the only sport where one much
smaller, weaker predator animal (the human) tries to control and become one unit of movement with
another much larger, stronger prey animal (the equine), with each having limited understanding of the
other. If an equine is frightened or provoked, it may divert from its training and act according to its
natural instincts. Such instincts may include, but are not limited to: stopping short, changing direction or
speed abruptly at will, shifting its weight from side to side, bucking, rearing, biting, kicking, or running
from what the equine perceives as danger. Serious injury or death may result from your participation in
this activity.
Your participation in this activity shall constitute a release from liability on behalf of SVR&R and its
officers and volunteers.
Signature of Participant: ___________________________________
Print Name: ____________________________
Address: ____________________________City: _______________________ State: ______
Zip: _______________
Phone: _______________________
_____/_______/
_______
e-mail:
____________________________
Date:
PARENT'S OR LEGAL GUARDIANS ADDITIONAL INDEMNIFlCATION (Must be completed for
participants under the age of 18)
In consideration of________________________________________ (print minor's name) (“Minor")
being permitted by SVR&R to participate in its activities and to use its equipment and facilities, I further
agree to indemnify and hold harmless SVR&R from any and all Claims which are brought by, or on
behalf of Minor, and which are in any way connected with such use or participation by Minor.
Parent or Legal Guardian Signature: _______________________________Print Name:
__________________________________
ACKNOWLEDGMENT OF CONFIDENTIALITY
Please read this document thoroughly. If you have any questions about this document, please refer them
to the individual presenting this document to you before signing it.
I acknowledge the fact that as a volunteer of Southern Valley Ranch and Rescue, I may have access to
confidential and personal private information necessary to carry out my duties as a volunteer. This
information may include but is not limited to the following confidential information:



Contributors’, adopters’, volunteers’, personal private information. This includes phone numbers,
addresses, and email addresses.
Business information relating to Southern Valley Ranch and Rescue.
Humane law case information.
I understand that approval to access and use this information in verbal, written, or electronic (stored in a
computer) form is a privilege. I also understand that access to information is granted to me on “need to
know” standards and the responsibilities as a volunteer.
I understand that I may not seek out information that is not required for my volunteer position. I also
understand that I may share information only with Board of Director approval. I agree to store and
dispose of information, which I use, in a way that ensures continued security and confidentiality.
I understand that the methods I use to get information may only be used for the performance of my
volunteer position. If I require special authorization to access computer-based information, I understand
that my computer sign-on information may only be used by me and all passwords and codes must be
given to the Board of Directors. I also understand that I may not give my sign-on information to anyone
other than the Board of Directors, and that this information is the same as my written signature. I accept
full responsibility for any use of my sign-on information.
I declare that I have read and understand this acknowledgment. I have had an opportunity to ask
questions and have them answered.
__________________________________
Name (Please Print)
__________________________________
Signature
___________________
Date
This document has been presented to the above-named volunteer. It has been fully explained and all
questions posed by said volunteer have been answered.
__________________________________
Signature
___________________
Date
RULES & REGULATIONS (detach and keep for your records and reference)
SVR&R rules must be strictly followed for the safety of the animals and people involved! If you do not
abide by these rules you will be asked to terminate your volunteering and leave the property immediately.
Please remember this is also a private residence; house and back yard are No-Admittance. Thank you for
understanding!

Plan on getting dirty, or muddy, wet or cold/hot…no sandals, flip flops etc. Boots that cover the
ankles are preferred.
 Volunteers are expected to arrive on time when scheduled. If unable to make the time, SVR&R needs
at least 24-hour notice.
 Visits are by Appointment Only!
 NO one is allowed in the barn without supervision unless they have completed necessary training.
 Although we greatly appreciate all efforts made by volunteers on behalf of SVR&R, the Board must
first approve all actions, correspondence, and solicitations. Volunteers may only handle horses, farm
animals, cats or dogs after they have been orientated and successfully completed ALL necessary
training.
 DO NOT FEED any animal anything without direct approval. (Some animals are on restricted/special
needs diets.)
 Turn OFF Lights and water when leaving for the night.
 ALL veterinary/medical questions go through Tiffany only. You are NOT authorized to call a vet to
inquire about SVR&R animals!
 Do not knock on private residence door unless it is an emergency (e.g. horse colicking, dog hurt,
bleeding).
 Do NOT open any horse stall door or pasture gate without prior approval.
 Do NOT enter any stall or pasture where there is a horse without permission. Always close gate
immediately behind you.
 Do NOT handle any horse, farm animal until you have been authorized.
 NO SMOKING in or around the barns, pastures, vehicles, or equipment. There is a designated area.
 Alcohol/drug use when volunteering at SVR&R or a related SVR&R function will NOT be tolerated.
 NO rough housing, screaming, or loud noises.
 All equipment must be cleaned and put back in its proper place.
 Sweep barn aisle if necessary
 All volunteers interested in adopting must complete the necessary forms, contracts and agreements.
SVR&R must approve all adoption placements to insure proper matching of the animals to their
families.
 SVR&R is not responsible for advice given by volunteers.
 Be respectful, kind, considerate to others. Be courteous, patient, and open-minded. We do expect you
to be willing to learn and enjoy yourself. SVR&R is a teaching environment with something to offer
the young, the old, the physically/mentally challenged, the horse person.
 Any mental or physical handicaps must be disclosed confidentially to SVR&R.
 If you volunteer for something off site (e.g. writing letters, research, fundraisers, etc.), we need
professional consistent follow through on your responsibilities.
 SVR&R reserves the right to deny a volunteering opportunity if SVR&R determines that the volunteer
is incapable of following all policies and guidelines OR if SVR&R policies and guidelines are not
adhered to.
Please use common sense, think SAFETY first.
“WARNING: Warning - Under Georgia law, an equine activity sponsor or equine professional is not
liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of
equine activities, pursuant to Chapter 12 of Title 4 of the Official Code of Georgia Annotated.” The same
applies to interaction with the dogs, cats or any other farm animal associated with Southern Valley Ranch
and Rescue INC.