Kitty City Volunteer/Foster Application
HHH Miniature Horse Rescue/Kitty City 
PO Box 4125 
Bismarck, ND 58502 
701.220.4449
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PERSONAL INFORMATION
Answers to all questions are required. Please write N/A if question does not pertain to you.
Date: *
Name: *
Street address or PO box: *
City, state and zip code: *
Phone: *
Occupation: *
E-mail address: *
Are you age 18 or older? *
Required
Do you have any medical limitations or do you take prescription medications? *
Required
If you answered "yes" above, please describe all medical conditions, medications or allergies Kitty City staff or emergency personnel should be aware of.
Name of health insurance carrier: *
EXPERIENCE AND INTERESTS
Answers to all questions are required. Please write N/A if question does not pertain to you.
How many years have you been working with cats? *
Why do you want to volunteer at Kitty City? *
Do you have other experience or talents you'd like to share? *
Which areas would you enjoy participating in? Experience is not necessary. *
Required
How did you hear about Kitty City? *
EMERGENCY CONTACT INFORMATION
Please notify the following person(s) in the event of a medical emergency.
Name of FIRST emergency contact: *
Street address or PO box: *
City, state and zip code: *
Best emergency contact phone number: *
Other emergency phone number, if applicable: *
Name of SECOND emergency contact: *
Street address or PO Box:
City, state and zip code: *
Best emergency contact phone number: *
Other emergency phone number, if applicable: *
PLEASE READ AND RESPOND TO THE FOLLOWING STATEMENTS:
I understand that cats are independent living beings with their own minds and, as such, can never be entirely predictable. *
Required
I understand there are always elements of risk, including permanent disability or death, due to Kitty City also being a large animal rescue for horses and other farm livestock. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to be alert and respectful of animals' intentions signaled with their ears and eyes and carried out with their teeth and claws. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to speak in a reassuring tone when approaching animals: *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to wear appropriate clothing, including durable shoes. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to pick up and replace equipment I have used and to CLOSE GATES I HAVE OPENED. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to know the locations of emergency telephones, ambulance and veterinarian phone numbers, and farm staff. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to know all fire emergency procedures. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to never be intoxicated. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to read and obey all posted information and warnings. *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to promptly comply with all verbal directions of HHHMHR staff and instructors.   *
Required
I am aware that, at all times when on HHH Miniature Horse Rescue property, it is my responsibility to refrain from acting in any manner that may cause or contribute to my injury or the injury of other people or cats: *
Required
I understand that this is only a partial list of responsibilities, and I must be safety conscious and exercise sound judgment at all times. *
Required
I understand that, if approved to be a Kitty City volunteer, I cannot bring friends, a spouse or children along when I am working. My volunteer status applies only to me. *
Required
LEGAL INFORMATION
Have you ever been convicted of a felony? *
Required
Have you ever been convicted of a sexual offense? *
Required
Have you ever been convicted of animal cruelty? *
Required
ADDITIONAL INFORMATION
Please provide any additional information you believe Kitty City should know about you and/or your application. Also, please share any questions you have at this time.
RELEASE OF LIABILITY
I, the undersigned, want to participate as a volunteer on and/or off premises at Triple H Miniature Rescue, also known as Kitty City and Atti's Eats. I understand that I will be in close proximity to several types of farm animals, including but not limited to horses, donkeys, cats, dogs, pigs and goats, which may expose me to some risk of injury because of the nature of the facility and the activities in which I will be engaged. In consideration of HHH Miniature Horse Rescue, Kitty City and/or Atti’s Eats allowing my participation, I, on behalf of myself and my heirs, administrators, personal representatives, assigns and children and spouse (if any), do hereby agree to hold harmless, release and discharge HHH Miniature Horse Rescue, Kitty City and Atti's Eats of and from all claims, demands, causes of action and legal liability, whether known or unknown, anticipated or unanticipated, due to the ordinary negligence of discharge. This release of liability includes the rescue’s officers, directors, members, agents, representatives, affiliates, volunteers and insurers. *
Required
YOUR SIGNATURE *
Checking the box below serves as my electronic signature and certifies that all information provided on this volunteer application form is accurate. I understand that I must submit a change of information form if any of the answers provided here are no longer accurate. *
Required
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