Volunteer Application

We love our Volunteers and cannot do what we do without YOU. We had over 14,000 hours of volunteer services in 2023! You do not need to have horse experience. WE will teach you.

Volunteers are people who give their time and services to benefit our programs. Some bring skills in horsemanship, while others bring skills in leadership and other experiences. Our volunteers make a difference in the lives of others. They are the heart of our programs and their dedication to our mission is the reason why we thrive.

Volunteers Must: Be willing to attend appropriate volunteer training. Be committed to volunteering at your scheduled time at least once a week per 10 week session. (we need a commitment)

We do not have an age requirement but a level of maturity is expected and all youngsters MUST be accompanied by an adult/parent/guardian who will be responsible for them while volunteering.

It is up to the staff of Healing Strides to determine if any volunteer is a good fit for the responsibilities that are asked of them.

Basic Info

First, let's get your basic info. We use Horse Business Manager for helping to schedule our volunteers. Please enter your name, email and mobile number. This info will be used to communicate openings, your schedule and important info from Healing Strides. Make sure you have access to both the email account and the mobile for texts.

First Name *

Last Name *

Phone *

Email *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Photo & Publicity Release

I consent to and authorize the use and reproduction by Healing Strides of VA and all photographs and any other audiovisual materials taken of me for promotional material, educational activities, exhibitions, or for any other use for the benefit of the program.

OPTIONS *

YES - I CONSENT to photos/publicity release

NO - I DO NOT CONSENT to photos/publicity release

Additional Info

Why do we need this info? Some volunteering roles and duties might require you to work with larger horses, carry heavier things, etc. We also work with Participants that have many different needs and the below information helps us make more informed decisions for our Participants and Volunteers. Please fill out whatever info you are comfortable sharing with us.

Date of birth *

Height

Weight

Gender

T-Shirt Size

Contact Info

Address *

Additional Address Info

City *

State *

Postal code *

Country *

Emergency Contact

Emergency Contact Name *

Emergency Contact Relation *

Emergency Contact Phone *

Experience and Health

Do you have any previous horse experience? *

Have you had any previous experience working with people with special needs? *

Have you ever been convicted of a crime?

If so, please explain below:

Enter your School or Employer name *

Pre-existing Health Conditions (put n/a if none) *

Please list all medication you are taking (including medical marijuana) (put n/a if none) *

Please note any allergies and if EpiPen or inhaler is used (put n/a if none) *

What is your general health status? Tell us about any special needs or health concerns *

Do you have health insurance?

Insurance Details - please put company and coverage dates

Medical Waiver

In the event emergency medical aid/treatment is required due to illness or injury during the process of reciving/giving services, or wile being on the property of HSVA or activity site, I authorize Healing Strides of VA to:

1) Secure an dretain medical treatment and transportation if needed.

2)Release client records upon request to the suthorized individual or agency involved in teh medical emergency treatment.

This authorization includes X-Ray, hospitalization, medication an dany treatment procedure deemed "life-saving" by the physician. This provision will only be invoked if the person consenting below is non-responsive in a medical emergency.

Waiver *

I accept the medical waiver

Volunteering

Volunteering is a powerful force that not only transforms the lives of those we serve but also enriches our own. It is through the selfless act of giving that we discover the true essence of community and compassion. By contributing our time and skills, we become instrumental in creating positive change and fostering a sense of unity.

How did you hear about volunteering with us? *

Word of Mouth

Received a volunteer information card in the mail or as a handout

Social Media/TV

Other

Do you have any special skills or training?

Marketing, advertising, promotions and social media

Special event planning, auction planning, procurement

Fencing, electrical, and building repairs or maintenance

Data entry

Important Information and Acceptances

General Liability Release

As a participant with Healing Strides of VA, I acknowledge and understand the risks and potential risks of a horseback riding program including but not limited to, (i) the propensity of an equine to behave in dangerous ways, which may result in injury or death to the participant or damage to property; (ii) the inability to predict an equine's reaction to sound, movements, objects, persons or animals; (iii) hazards of surface or subsurface conditions whether known or unknown; (iv) the condition and age of the equipment or tack, however, I feel that the possible benefits to myself and the participant I work with are greater than the risk I assume. I hereby, intent to be legally bound, for myself, my heirs and assigns, executors or administrators, and waive and release forever all claims for damages against-Healing Strides of VA, their board of directors, instructors, therapists, aides, volunteers, employees and their respective families, for any and all injuries and/or losses I may sustain while participating in Healing Strides of VA. I further certify that the foregoing statements and representations are being made by me knowingly, freely and voluntarily, and I understand that Healing Strides of VA is expressly relying upon the foregoing statements and representations in permitting me to participate in programs at Healing Strides of VA. *

I accept the release of liability

Confidentiality

ACKNOWLEDGMENT OF HSVA CONFIDENTIALITY POLICY

* Due to the nature HSVA's programs, we are entrusted with sensitive personal information. Our clients are entitled to assurance of protection from unwarranted invasion of personal privacy. The Privacy Act, State and Federal Laws, regulations from licensing agencies and our basic constitutional rights are designed to protect us all from unwarranted invasion of privacy.

* No information about a client, including enrollment or residence, in written or any other form, may be disclosed to any person or organization without proper authorization. (The only exception is in a life-threatening emergency, in which necessary medical information may be disclosed to emergency personnel to expedite treatment). HSVA staff is responsible for reviewing all requests for information to ensure that the proper authorization has been obtained.

* Again, our records contain sensitive client information, which is protected by law from unauthorized disclosure. HSVA holds the moral and legal obligation to protect the interests of both our clients and employees. By signing the confidentiality agreement, I commit to protect the privacy of HSVA clients, both past and present.

* I have read the above and agree to maintain this policy during and after my tenure with HSVA. I realize that this document will become a permanent record at HSVA. I further realize that failure to comply with the policies on confidentiality could impact my involvement at HSVA.

Check below: *

I accept the confidentiality release

Consent to Electronic Signature

By checking this box you consent to an electronic signature. *

I consent to Electronic Signature