First & Last Name:

Street Address:

City:

State: --------- Select a State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

5 Digit Zipcode:

Home phone:

Cell phone:

Email:
*We use this address for staff only animal care updates and will never release your information to any outside sources.

Date of birth: --- January February March April May June July August September October November December --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 --- 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994
*You must be at least 18 years old to volunteer at our facility.
If you are under 18 and would like to find other ways to help our organization, please email awintrode@gmail.com or have your parent call us at (636) 492 . 1610.
Thanks!*

Emergency Contact Person:

Emergency contact number:

Personal Information

If you have any physical limitations, special skills, or previous animal related experience that you would like us to be aware of, please provide that information below::

It is strongly recommended that animal care volunteers have a current tetanus inoculation, within the last ten years.
We work with metal cages every day in our facilities and we prefer to take this precaution.
If you are not currently vaccinated, you can inquire about low cost options through the St. Louis County Health Department, at (314) 615 . 0400.
Check the following box if you have had a tetanus shot within the past 10 years?:

Areas of Interest

Animal Care

Our animal care shifts are seven days per week, 365 days per year. (Raccoons don't care when it's a holiday!)
Our morning shift starts at 9:00am and ends at 1:00pm. Our evening shift starts at 7:00pm and ends at 11:00pm.
We ask that new volunteers work one shift per week to start, and can begin as soon as possible.
The shift work consists working with a shift lead and other volunteers to feed the animals, assist in medications when needed, clean cages, prepare formula and fruit/vegetables for the animal's needs, as well as general clean up before the end of each shift.
We provide all the necessary training and materials to perform the duties required and only ask that volunteers wear "yard-work" type clothing that is okay to get messy, and minimal, if any jewelry. (Raccoons love shiny things!)
Please also be aware that part of our facility is maintained at temperatures to match outdoor temps for animal transitions, so please dress or prepare accordingly.
You may get dirty, and you may even get wet (we have baby beavers), but we hope that you will also find friends and lots of fun!
Please indicate below what shifts you are currently available to work with us and we will discuss in more detail when we call you to confirm.

Maintenance

We often have need for squirrel boxes, raccoon den boxes, and general repair and building maintenance. If this is something that you have experience with (carpentry, plumbing, HVAC, etc.) and would be willing to help out if/when needed, please check this box to be notified when the need arises. :

Fundraising

We have many events each year to promote awareness of our facility and to raise much needed funds. These events include our Spring and Fall Open House, Trivia Nights throughout the year, Donation Drives, Business Partner Cooperatives, and many others. If you have previous experience with this sort of work, or would enjoy participating in these types of special projects, please check this box. We will notify you via email or telephone when the need arises and often times these projects can be accomplished from home during your free time away from the clinic. We also appreciate any fund raising ideas that any of our volunteers might have.:

Office Work

Our clinic sends out paper newsletters multiple times per year and we always need help folding and sorting before mailing, as well as the work associated with updating our web site, filing, and record keeping. We also have a large call volume during our spring and summer months and are always in need of extra help in returning those calls and educating the public. If this is something that you would be interested in doing, or if you have any special office/administrative/technical skills, please check this box and we can discuss in more detail while confirming your start date.:

Waiver & Release . Every volunteer with the WRC must agree to the following before working at our facility. Our shift supervisors and species specialist take every opportunity to ensure that our volunteers are properly trained, prepared, and personally willing and ready before allowing direct contact with any of our animals. Keeping that in mind, we still do require that a release is signed before working with our facility. If you have any questions about this process, please feel free to contact us prior to submitting this application. I hereby waive and release, indemnify, hold harmless and forever discharge Wildlife Rehabilitation Clinic, and its agents, employees, officers, directors, affiliates, successors, and assigns of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities of every kind and nature, whether known or unknown, in law and equity, that I never had or may have, arising from or in any way related to my participation in any of the events or activities conducted by, on the premises of, or for the benfit of Wildlife Rehabilitation Clinic, that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful, or wanton misconduct. I understand that the activities that I will participate in and that the animals that I will care for may be dangerous and may cause serious or grievous injuries, including bodily injury. I understand that I will be in contact with, but not limited to, squirrels, raccoons, opossums, rabbits, skunks, groundhogs, fox, coyote and beaver. I understand that as with most animals they may act in an unpredictable way to sounds, movements, other people, or other animals that could result in injury. On behalf of myself, my heirs, assign and next of kin, I waive all claims for damages and injuries sustained by me or my property, that I may have against the aforementioned and released party to such activity. By this waiver, I assume any risk and take full responsibility and waive all claims of all personal injury, death, or damage to personal property, associated with the Wildlife Rehabilitation Clinic. My digital signature is proof of my intention to execute a complete and unconditional waiver and release of all liability to the full extent of the law. I understand that by signing this waiver I am giving up considerable future legal rights. I sign this agreement voluntarily, under no duress or threat of duress, without inducement, promise or guarantee that I am 18 years of age or older and mentally competent to enter into this waiver.:
I Agree