Student Service

Name: Closed 1/21
Start: 2025-01-21
End: 2025-01-21
Location: Humane Society of Carroll County

Home / Student Service

Volunteers ages 5-15 should fill out the below form. You will then be redirected to your next steps.

Ages 16 & older, click here to register.

Student Service Registration

YOUR INFORMATION
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Age*
Please note anyone under 16 must be accompanied by an adult for the entirety of their service.
Address*
Street Address City State ZIP Code
Home Phone*
Cell Phone
Email*
Incoming Grade*
Emergency Contact*
Emergency Contact Phone Number*
What is your availability? (Weekday AM/PM, Evenings, Weekend)*
AGREEMENT / RELEASE:
I hereby release the Humane Society of Carroll County, Inc.(HSCC),from any and all responsibility and or liability of any nature whatsoever in connection with any and all activities which I may participate in on behalf of or in any way associated with HSCC and any and all injuries of any nature whatsoever which may arise out of, result from or be associated with said activities. I hereby waive all claims to damage or lost of my person or property which may be caused by any act, or failure to act, of the HSCC, its Board of Directors, agents or employees. Furthermore, I will comply with all regulations, policies and procedures of the HSCC and understand that my failure to do so will result in my termination as a volunteer. I hereby, execute this release freely and voluntarily knowing that same is a legal document, and further recognizing that I had the opportunity to seek legal counsel pertaining to this document prior to signing.
I have read the above statement*
- Agree
- Disagree
Signature (Volunteer's or Guardian's)*
By typing in my name, I am signing that I have read and agree to the release.
First Last
Who Signed?*
- Volunteer
- Volunteer’s Parent/Guardian
Date*
MM slash DD slash YYYY
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