Panther Creek Health Volunteer Application

We welcome you to volunteer with us at Panther Creek Health! Our volunteers support our programming in many ways. From supporting our equine care team, to helping our therapists with groups, gardening and equine assisted learning, to exercise riding to keep our horses fresh and bright – volunteer partners keep our program afloat! Volunteers assisting with youth activities will complete a background check before they begin service. Fill out the below form and we will contact you soon.

At this time, we are accepting volunteers ages 16 and up.

We welcome to you apply to volunteer with Panther Creek Health!

Full Name(Required)

Best Phone(Required)

Hidden

Best Phone Number

Email(Required)

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide up to three days and times of day (morning, afternoon, evening) that you are able to serve.

Panther Creek Health operates several programs which serve youth and adults in the community, and often uses equines in the work. Please offer your level of expertise with horses within a farm setting.(Required)

Please offer specific skills that you believe could be used to support Panther Creek Health (administrative, equine specialist, youth worker, horse care support)(Required)

Have you ever volunteered in a therapeutic or healthcare setting?(Required)

Have you ever served in a child/youth serving environment (please offer details)?(Required)

Have you ever been convicted of, or pleaded guilty or no contest to, any crime?

Yes

Have you ever participated in, or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct?

Yes

Are you aware of any traits or tendencies in yourself that could pose any threat to children, youth, or others?

Yes

Please provide two independent references that are unrelated to you. Past leaders familiar with your performance and skillset are preferred. Phone and email are all that is required!

Volunteer Release

Please type your full name into the provided box. This agreement acts as a legal signature, allowing for reference and background checks to be performed on the potential volunteer.

I recognize that Panther Creek Health is relying on the accuracy of the information I provide on the Volunteer Application form. Accordingly, I attest and affirm that the information I have provided is absolutely true and correct. I authorize the organization to contact any person or entity listed on the Volunteer Application form, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications. I voluntarily release the organization and any such person or entity listed on the Volunteer Application form from liability involving the communication of information relating to my background or qualifications. I agree to abide by the policies and procedures of the organization and to protect the health and safety of the children, youth or equines assigned to my care or supervision at all times.(Required)