Foster Waiver

Foster and Volunteer Waiver/ Confidentiality Agreement

Agreement for Assumption of Risk, Waiver and Release of Liability and Indemnification:*
I have read and understand the above Confidentiality Policy of the Ark-Valley Humane Society, Inc. and I agree to abide by the policy.*
The Confidentiality Policy applies to employees, former employees, contractors, consultants, temporary employees, volunteers, board members and all other workers at the Company, including all personnel affiliated with third parties. As a condition of employment and continued employment with the Company, all employees are expected to conduct themselves in a manner which protects confidential information. All non-employee parties covered under this policy are expected to conduct themselves in a manner which protects confidential information. This policy is not intended to prevent disclosure where disclosure is required by law and any legal requirements will take precedence over the Company policy. Access to confidential or non-confidential information contained on internet/intranet/extranet systems shall be based on the job/role needs as determined by the Executive Director or Chair of the Board of Directors as appropriate. Confidential information shall include, but not be limited to, addresses, phone numbers, account information, passwords, pass codes, state or government issued driver’s license or identification card numbers, government passport numbers, birth dates, social security numbers, personal identification numbers, credit card numbers, bank account numbers, other Financial Transaction Devices (as defined in Colorado Revised Statutes 18-5-701(3)), biometric data (as defined in Colorado Revised Statutes 6-1-716(1)(a)), credit history, wage and salary information, medical data, applicant and personnel information, employer, student or military identification numbers and employee background checks. Other information that may be deemed confidential includes, but is not limited to, client information (including pet ownership unless authorized by the client and surrendering party), all donor information (unless specifically authorized by the donor), legal impound/holds. All necessary steps to prevent unauthorized access to this information shall be taken. 1. It is recommended that any information that users consider sensitive or vulnerable should be encrypted. 2. Removing any asset or media that contains confidential information from the Company premises (computers, laptops, hard drives, flash drives, backup tapes/disks, paper records, cloud-based storage) is prohibited without explicit prior approval by the Executive Director. 3. If confidential information is approved for removal from the Company premises, under no circumstances should it be accessible to any individual or individual(s), including, but not limited to, family members, computer service technician, without the explicit prior approval by the Executive Director.
Volunteer Waiver
Please sign your initials in the boxes below each question.
I have read and understand the Foster Cat/Dog PowerPoint(s) and Volunteer Handbook, and I agree to abide by the policies outlined in them.*
I agree to comply with all the rules and regulations which may be established from time to time by AVHS.*
I agree to disclose any physical or psychological limitations to appropriate staff before participating in any activity. Since I may be interacting with animals, healthy and sick, big and small, and may be lifting, carrying, moving, or otherwise engaging in physical labor, I will be mindful of my own limitations and will inform staff immediately of any such limitations.*
I agree to hold absolutely confidential all information that I may obtain concerning patrons or animals while volunteering at AVHS.*
I fully understand that Ark-Valley Humane Society expects high standards of moral and ethical treatment of animals under its care. I agree to adhere to these standards in my voluntary capacity and exercise compassion, care and positive training methods with all animals.*
I agree to treat all AVHS staff, volunteers, property, tools, and equipment with respect and kindness. I will also return all AVHS property when my volunteer relationship ends.*
I agree to treat patrons and other guests of Ark-Valley Humane Society with courtesy, sensitivity, and professionalism. I will seek management for any questions or situations beyond my training.*
I agree to report any relevant information regarding an animal in a timely manner. If bitten or otherwise injured, I will immediately alert management and/or staff.*
I give AVHS and its sponsors permission to use and publish photographs and videos taken of me as a volunteer, such as in their newsletters, websites and online media, for publicity, promotional or educational purposes.*
I acknowledge all services provided by volunteers will be performed on a strictly volunteer basis, and that I will receive no pay or compensation of any kind, that I will not be an employee of AVHS nor otherwise derive any benefits normally available to employees of AVHS, and that AVHS shall incur no liability of any nature as a result of my volunteering for AVHS.*
I acknowledge that I am responsible for providing my own medical, liability, and auto insurance while volunteering for AVHS. I understand that I am not covered by workers’ compensation, including when driving a vehicle or transporting an animal.*
I understand that either AVHS or I can terminate this relationship at will.*
I am voluntarily participating in the activities of AVHS with full knowledge of the risks and dangers involved. I understand that as a volunteer, I will be in close contact with dogs, cats and other animals. Many of these animals are strays and may be scared, hurt or injured. Some animals may have unpredictable temperament. Such work entails risk of personal injury due to proximity to animals, equipment, driving, and other considerations. These include, but are not limited to, being bitten, kicked, clawed, tripped, exposed to parasites, such as fleas, ticks and ringworm, and possibly exposed to infectious diseases, such as rabies. These risks may be caused by my actions or the actions of others.*
I (and my parent(s)/guardian(s) if applicable) knowingly assume all risks of injury, whether identified above or not, and risk of death or damage to myself and/or my personal property may result from my voluntary choice to participate in the activity described in this Agreement and assume full responsibility for participation in this activity.*
I (and my parent(s)/guardian(s) if applicable) understand that I am solely financially responsible for any and all necessary medical care resulting from injury occurring while volunteering at AVHS, whether on-site or off-site at associated AVHS activities.*
In consideration of being permitted to perform volunteer services for Ark-Valley Humane Society, I, on behalf of myself, my heirs, and personal representatives, hereby release, discharge, indemnify and hold harmless AVHS and its assigns, successors, agents, staff, board of directors, employees, sponsors, and representatives from any and all claims, causes of action, or demands of any nature or cause whatsoever, including costs and attorney fees, arising out of or relating to my volunteering with AVHS.*
Foster Waiver
Please sign your initials in the boxes below each question.
Foster Volunteer shall provide the animal(s) with good care, including but not limited to healthy food, clean water, warm shelter in a loving, humane home, grooming, training and adequate exercise.*
(Cats only) Cat(s) will not be allowed outdoors.*
(Dogs only) Dog(s) will not run outside unsupervised. Foster Volunteer will maintain a fenced yard or be able to properly exercise and keep dog(s) safe. Foster Volunteer will not tie up or chain dog(s*
As between Foster Volunteer and Ark-Valley Humane Society (AVHS), the animal(s) and any offspring shall remain the sole property of AVHS*
The animal(s) shall be returned to AVHS upon request by AVHS, or if Foster Volunteer is no longer able to adequately care for the animal(s), or if Foster Volunteer is relocating, vacationing, or away from their home for an extended period of time. Exceptions may be made, but will need written approval from AVHS management.*
Foster Volunteer agrees to adhere to all zoning and animal control codes, and all local, City, County, and State of Colorado ordinances.*
Foster Volunteer shall have the animal(s) vaccinated annually and treated immediately for any illness/injuries. Foster Volunteer understands that AVHS will provide basic food and vaccinations, as well as medication for existing ailments. In the unfortunate event that the animal(s) become ill during foster care, Foster Volunteer agrees to call AVHS to discuss a course of action. Any vet appointments made for the animal(s) must receive prior approval from AVHS. Any medical expenses incurred, without prior approval of AVHS, are the sole responsibility of Foster Volunteer.*
Foster Volunteer agrees that should the animal(s) require extensive medical treatment, AVHS may request the immediate return of the animal(s) and may euthanize the animal(s) for humane reasons. In the unfortunate event that the animal(s) becomes so ill during foster care as to warrant humane euthanasia, Foster Volunteer will notify AVHS before having the animal(s) euthanized and will supply AVHS with medical documentation from his/her veterinarian verifying euthanasia and the reason for it.*
Foster Volunteer will not physically, mentally, or emotionally abuse or neglect the animal(s) or allow it/them to be abused or neglected. Foster Volunteer authorizes AVHS, at its sole discretion, to determine whether or not the animal(s) has/have been abused or neglected while in Foster Volunteer’s possession and to reclaim the animal(s).*
AVHS reserves the right to perform a home inspection at any time. If AVHS demands its return for any reasonable cause, Foster Volunteer agrees to return the animal(s) to AVHS*
If the animal(s) is lost, Foster Volunteer will immediately notify AVHS. Foster Volunteer will immediately notify AVHS of any change of contact information (address, phone number(s), or email address). Foster Volunteer authorizes any individual or agency to release the animal(s) back to AVHS if it/they is/are found abandoned, running at large or is/are brought to a shelter facility for any reason. Foster Volunteer understands that AVHS may not return the animal(s) to Foster Volunteer’s care if lost.*
Foster Volunteer agrees to return the animal(s) to AVHS no later than the date agreed upon by Foster Volunteer and AVHS staff. (Please note-return date is subject to change if authorized by AVHS staff.)*
Risks are involved in providing foster care. Foster Volunteer acknowledges and agrees that animal bites or other injuries to humans, property, and other animals occur and that all animals can carry and transmit parasites, diseases, including zoonotic diseases that can be transferred from animals to humans. Foster Volunteer shall indemnify, defend, and hold harmless AVHS and its officers, directors, agents, volunteers, and employees from and against any and all liability, damage, loss, cost, and expense incurred as a result of any injury or loss, including, without limitation, any bodily injury or property damage to Foster Volunteer, Foster Volunteer’s family, others or other animals while engaged in the performance of foster services or any other activity related to AVHS. Foster Volunteer also understands and agrees that as a foster volunteer for AVHS, they are a humane agency staff person pursuant to Colorado Revised Statutes §§ 18-9-204.5 and 13-21-124.*
In consideration for being accepted as a volunteer, by signing below Foster Volunteer agrees for herself/himself, and her/his executors, administrators, heirs, next of kin, successors and assigns, to waive, release and forever discharge AVHS, its officers, directors, agents, volunteers and employees, from all claims or demands of any nature whatsoever, including personal injury, sickness, death, property damage, damage to other animals and expenses (including attorney’s fees) which arise out of or relate to Foster Volunteer's participation in fostering or any other activity Foster Volunteer engages in related to AVHS.*
By signing below, Foster Volunteer further agrees to indemnify and hold harmless AVHS, its officers, directors, agents, volunteers and employees, from all claims or demands of any nature whatsoever (including attorney’s fees) made by any third party which arise out of or relate to Foster Volunteer's participation in volunteer activities and/or any other activity Foster Volunteer engages in related to AVHS.*
AVHS is not liable for any claims, legal actions, losses, injuries, damages, costs, expenses, or liabilities whatsoever in connection with Foster Volunteer’s care of the animal(s), including, but not limited to, losses, injuries, damages, costs, expenses, or liabilities incurred by members of Foster Volunteer’s family, neighbors, other animals or others that might enter Foster Volunteer’s home.*
Foster Volunteer agrees to reimburse AVHS for all actual and reasonable expenses incurred by way of Foster Volunteer’s violation of any term or provision of this Agreement, including, but not limited to, reasonable attorneys’ fees and costs.*
This Agreement is made pursuant to and governed by the laws of the State of Colorado. This Agreement represents the entire agreement of the parties as to the subject matter contained herein, and may not be amended except by in writing executed by all of the parties. This Agreement shall be binding upon and inure to the benefit of the respective heirs, successors and assigns of each of the parties hereto. In the event any one or more of the provisions of this Agreement is held to be invalid, illegal or unenforceable in any respect by any court or other entity having the authority to do so, the validity of the remaining provisions hereof shall in no way be affected or disturbed.*
Foster Volunteer acknowledges that the statements contained within this Agreement are true to Foster Volunteer’s knowledge and further acknowledges that the representations made herein are material to AVHS’s consideration of this Agreement and that AVHS will rely on the truth of the statements made herein. If any information contained herein is deemed to be falsified by AVHS, Foster Volunteer agrees to immediate surrender of the animal(s) to AVHS, at the sole expense of Foster Volunteer.*
Foster Volunteer is at least 18 years of age*
Name*
First Last
Email Address*
Signature*
Today's Date*
MM slash DD slash YYYY

719-395-2737

CONTACT US

Foster and Volunteer Waiver/ Confidentiality Agreement

Volunteer Waiver

Foster Waiver