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                          SCHOOL / YOUTH GROUP 
                             VOLUNTEER APPLICATION 
Complete and return this form to: 
E‐mail: lynnmiller@nyanimalrescue.org  
 
STEP 1. Please send the following to lynnmiller@nyanimalrescue.org: 
1. A separate list of program participants / students and their ages.  
a. Within the email message is sufficient 
2. A list of Monitors & their contact info (email & cell) 
a. Within the email message is sufficient 
 
STEP 2. Complete all information below:  
 
Name of School / Group:  
 
Address:  
 
City/Town: State: Zip Code:  
 
Contact Information 
Full Name/Title of Contact Person:  
Phone:  
E‐mail:  
 
Alternate Contact Information 
Full Name/Title of Alt. Contact Person:  
Phone:  
E‐mail:  
 
Approximately how many people are in your group?  
 
What is the approximate age range of the group?  From ________________ to __________________. 
 
DATES / DAYS REQUESTED:  
 
LOCATION REQUESTED: 
Windsor Terrace 153 E 3rd
 St, Bkln NY 11218 
*TUESDAYs thru FRIDAYs 
 
Sunset Park 551 39TH
 St, Bkln NY 11232 
*MONDAYs thru THURSDAYs 
 
CONSENT FOR MINORS: By signing this form, I acknowledge that our organization has obtained 
permission from parents/guardians of minors to participate in this group volunteer project. I understand 
that rescue activities have potential risks and assume responsibility for minors in our group. I 
acknowledge that the above information is correct and true to the best of my knowledge, and that I 
have read and agreed to the liability agreement on the following page. 
 
 
SIGNATURE OF GROUP REP: ________________________________________ Date: ________________ 
OFFICE USE ONLY
Date 
Rec’d 
 
 
 
 
Mandatory School/Youth Group Interviews:  
 
1. Upon arriving at our Windsor Terrace facilities, all group participants, students & monitors are 
required to check in, submit all required individual paperwork and meet with Valerie 
Greenblatt, Kennel Manager, in person for face to face group interview before being allowed to 
visit, tour or volunteer in any capacity. 
 
2. Upon arriving at the Sunset Park facility, all group participants, students & monitors are 
required to go to the second floor (walkup 2 stories of stairs) to the Administration Office to 
check in, submit all required individual paperwork and meet with SCAR Staff on Duty in person 
for face to face group interview before being allowed to visit, tour or volunteer in any capacity. 
 
Dog Walking Dos: 
 
1. Dogs can be walked for a minimum of 15 minutes and a maximum of 45 minutes. 
2. Dogs can only be walked by volunteers over the age of 16. 
3. You must sign the dogs in and out EVERY time.  
4. Dog leashes must be held securely and dogs must be kept on a short leash. 
5. Dogs must stay in the neighborhood in case we need you to bring the dog back. 
6. Alert the staff about anything wrong with the dogs (limping, blood in the stool etc.) 
7. You MUST scoop the poop! 
 
Dog Walking Don’ts: 
 
1. Do not open any dog cages or put any dog away. ALWAYS ask the staff for assistance. 
2. Never allow the dogs to be off leash. 
3. Do not let the dogs interact with other dogs. They may be aggressive or ill. 
4. Do not let the dogs eat anything off the ground. Some things may be toxic for them to eat. 
5. Never leave the dogs tied up or unattended at any time. 
6. Do not bring the dogs to your home. 
7. Keep the dogs off private property. 
 
CONSENT FOR MINORS: By signing this form, I acknowledge that our organization has obtained 
permission from parents/guardians of minors to participate in this group volunteer project. I understand 
that rescue activities have potential risks and assume responsibility for minors in our group. I 
acknowledge that I have read, understand and agree to the above stated requirments and that I have 
read and agreed to the liability agreement on the following page.  
 
 
SIGNATURE OF GROUP REP: ________________________________________ Date: ________________ 
 
 
 
 
 
 
SCAR SCHOOL / YOUTH GROUP VOLUNTEER PROGRAM  
WAIVER & AGREEMENT  
Liability Release (A) 
1. We agree to volunteer our time and talents to assist the Sean Casey Animal Rescue, Inc. (SCAR) in carrying out 
its mission. 
2. We understand that we will not receive any monetary compensation and that we are not eligible for any 
benefits offered to SCAR employees. 
3. We understand that while on duty and performing functions authorized by SCAR, we are not covered for 
accident insurance and liability insurance. We accept responsibility for the individual’s or group’s private 
insurance. 
4. We understand that with proper notification (24 hours) either our group or SCAR may cancel this agreement 
at any time. 
5. We agree to: 
5.1. Complete the duties that we agree and are assigned to do to the best of our ability. 
5.2. Arrive on time and notify staff when we are unable to work the shift or hours we had planned. 
5.3. Be courteous and respectful to the public, volunteers, and staff. 
5.4. Abide by the laws of New York State and SCAR policies, rules and regulations. 
6. SCAR agrees to: 
6.1. Provide necessary training to do our assignments. 
6.2. Provide a safe working environment 
 
Confidentiality Statement (B) 
As a volunteer for the Sean Casey Animal Rescue, Inc., I acknowledge that I may have access to confidential and 
privileged information and materials obtained through my affiliation with the Sean Casey Animal Rescue, Inc. I 
shall not share any such information or materials with anyone within or outside the organization not intended to 
receive them. 
 
Consent and Release for Publication of Photographs (C) 
I, the undersigned, hereby grant the Sean Casey Animal Rescue, Inc., permission to take photographs of me, and 
irrevocably consent to and authorize the use and reproduction by the Sean Casey Animal Rescue, Inc., or anyone 
duly authorized by the Sean Casey Animal Rescue, Inc., of any and all such photographs, for any legitimate 
purposes, including for advertising, trade, and editorial purposes, at any time in the future in all media now known 
or hereafter developed. I also consent to the use of my name in connection with such photographs. I hereby 
release, indemnify and hold harmless the Sean Casey Animal Rescue, Inc. and its officers, directors, agents and 
employees from any and all claims which may result at any time by reason of the use of my image and name, 
including, without limitation, claims or privacy. My heirs, executors, administrators and assigns shall be bound by 
this consent and release. I am over the age of 18. 
 
_________________________________________        ________________________________________ 
Name (please print)           Signature 
 
Section A — Notice of Occurrence, Claim or Suit 
In cases of emergency, the affected party should dial 911 immediately. 
When an occurrence takes place the affected person shall immediately notify the Sean Casey Animal Rescue, Inc. 
Director of Operations (347‐599‐1500 ‐ operations@nyanimalrescue.org) of any accident or loss and forward all 
notice and legal papers received. Notice shall be given immediately after the person has knowledge of the 
occurrence. It shall include all reasonably obtainable information about the time, place and circumstances of the 
occurrences as well as the names, addresses, telephone numbers and other pertinent information of all individuals 
involved. No person shall, except at individual expense, voluntarily make any payments, assume any obligation or 
incur any costs. 

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