Volunteer/Staff Information Form and Health History

Volunteer/Staff Information and Health History

Volunteer/Staff Information and Health History

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Equine assisted therapy programs can be physically and emotionally demanding. Do you have any heart, back, bone, joint or muscle conditions that we should be aware of in order to keep you, our instructors and our veterans safe? In case of emergency, do you have any conditions that emergency services should be aware of? *If you are unable to lift 50 lbs during volunteer activities, it is your responsibility to inform the WarHorses staff
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I (printed below) authorize WarHorses for Heroes to receive
information from any law enforcement agency, including the police departments and sheriff’s departments, of this
state or any other state or federal government, to the extent permitted by state and federal law, pertaining to any
conviction I may have had for violations of state or federal criminal laws, including but not limited to convictions
for crimes committed upon children. I understand that such access is for the purpose of considering my application
as an employee/volunteer, and that I expressly DO NOT authorize the center, it’s affiliate center Oak View Stables,
any directors, officers, employees, or other volunteers to disseminate this information in any way to any other
individual, group, agency, organization or corporation.
I understand that all information (written and verbal) about participants and volunteers at WarHorses for Heroes is
confidential and will not be shared with anyone without the expressed written consent of the participant and his/her
parent/guardian in the case of a minor.
I understand that the information provided above is accurate to the best of my knowledge. I know of no reason why I
should not participate in this center’s program.

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