Volunteer Parental Consent Form Name of child under 18:* First Last Birthdate of child:* Month Day Year Names of legal parent (s) or guardian(s):* Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home or Cell Number of parent(s):*Does the parent(s) have a work phone number?* Yes No Work number of parent(s):*Work number of parent(s):Email of parent(s):* Is your child comfortable around cats?* Yes No Does your child have any cat related allergies?* Yes No Has your child ever volunteered for an animal rescue previously?* Yes No Name(s) of rescue organization(s) your child has volunteered for:*Does your child have any health issues Kitty Devore Rescue should be aware of?* Yes No Please explain health issues:*I, the parent or guardian of the above mentioned child, affirm the Petsmart In-Store KD Volunteer Application and Agreement was completed and submitted by my child with my approval and consent and will ensure their compliance to the agreements outlined within the document.* I consent I don’t consent I, the parent or guardian of the above mentioned child, affirm I will be in attendance and physically present with the child named in this consent form as they perform their voluntary duties and carry out their agreed upon shifts at the Santa Ana Petsmart adoption center.* I consent I don’t consent I, the parent or guardian of the above mentioned child, give my voluntary consent to his/her participation in Kitty Devore Rescue adoption events and group activities.* I consent I don’t consent I hereby release Kitty Devore Rescue, the Kitty Devore administrators, Board of officers, members and agents from any and all liability resulting from events beyond control.* I release all liability I don’t release all liability In the event of an accident, injury, or illness, the above stated and its agents do not assume any responsibility or obligation to provide financial assistance or other assistance, including but not limited to, medical, health, or disability insurance, in the event of an accident, injury, illness, death or property damage. In the event of an accident, injury, or illness, the above stated and its agents will make every effort to contact parents/guardians immediately if necessary and in the event they are not present.* I agree I don’t agree I release Kitty Devore Rescue, the Kitty Devore administrators, Board of officers, members and agents for any loss, personal injury, accident, misfortune, or damage to the above name or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named child.* I agree I don’t agree Signature of Legal Parent or Guardian (Full Legal Name Required):* First Last Today’s Date:* Month Day Year
