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ADULT VOLUNTEER
RELEASE INDEMNITY AND ASSUMPTION OF RISK STATEMENT
In consideration of the permissions for me to enter the property and facility known as East Maui Animal Refuge, bearing Tax Map Key No. (11) 2-8-009-017, and located at 25 Malu Aina Pl. Haiku, Maui, HI, I agree to release indemnity and hold blameless the East Maui Animal Refuge from any and all claims of damages, losses, and/or injuries to me which may result from my entry onto such property. I agree to assume the risk of any damages, losses, and/or injuries that may result from my entry onto such property.

DATE:

NAME: ADDRESS:

CITY STATE:  ZIP: 

 EMAIL: PHONE:

I have read, understand and agree to all of the above:

ELECTRONIC SIGNATURE:

ID #

Preferred Shift:      Day         a.m.  p.m.

Preferred Area:     Cattery: Aviary: Big Animal: Power Wash: Any/All:

Secretarial:          Fund Raising:

  Special Skills/Interests?
  

                       

 

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East Maui Animal Refuge - 25 Maluaina Place - Haiku, Hawaii 96708 - (808)-572-8308