Volunteer Application (for individuals) Name* First Last Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Cell Phone*Home or Alternative PhoneEmail* Date of Birth* How did you hear about volunteer opportunities with the Greenwell Foundation? (Check all that apply) Word of mouth Internet Flyer Newspaper If "Word of Mouth," please tell us who told you about Greenwell:If "Other," please tell us how you heard about volunteer opportunities with the Greenwell Foundation:Are you a veteran?When are you generally available? (Check all that apply) Weeknights Weekdays Weekends Are there any days/times that you are not available:Are you available to volunteer: Weekly Monthly On-call What length of time do you have in mind to volunteer with us? 6 months 1 year Indefinitely! Seasonal Special Events only How would you prefer to work? (Check all that apply) Independently Small Group No preference Please indicate which, if any, of the following Equestrian Program tasks you are interested in: In Arena - Assisting with riding lessons (Side Walking/ Horse Leading) Open Barn (Outreach Support) Barn Support (Cleaning, Picking stalls, etc.) Do you have any experience with horses? Please be specific:Do you have any experience working with individuals with special needs?Please indicate which, if any, of the following Nature Time or Camp Greenwell activities you are interested in: Assisting or leading special crafts Assisting or leading sports activities Special visitors to teach a skill If interested in teaching a skill, please describe:Please list any other skills, abilities or interests you have that may contribute to the work of the Greenwell Foundation:Emergency Contact Name:*Relationship (friend, parent, etc.):*Emergency Contact Phone:*Photo Release: By entering my name in the field below, I hereby acknowledge that any and all photographs and any other audiovisual materials taken of my child/myself by the Greenwell Foundation may be used for promotional printed material, educational activities, and website display, or for any other use for the benefit of the program unless written notification is submitted prior to the start of my service.*Background Check: By entering my name in the field below, I understand that I may need to undergo a background screening. (A background screening may be required for some volunteers within our program who are over the age of 18 in order to protect the welfare of our clients, staff, and other volunteers. Upon receiving your application and outlining your specific position, you will receive any necessary instructions to complete a background screening. Please understand that all of your information will be kept completely confidential and that you have the right to review your results.)*Liability release: By entering my name in the field below, I agree to the following (as either the volunteer or parent/guardian of minor): In consideration of participation in the activities and programs of the Greenwell Foundation/DNR I do hereby forever release the Greenwell Foundation and the Maryland Department of Natural Resources (DNR), their officers, directors, advisors, supervisors, instructors, staff, and members, from any and all claims, demands, suits, or liabilities which might otherwise arise by virtue of any injury which may occur to myself. I further agree to indemnify and hold harmless each and everyone of them from any and all claims, demands, suits, or liabilities which might otherwise arise by virtue of injury by myself or any horse under my direction of control or ownership.*Consent to Treat: By entering my name in the field below, I do authorize any officer, director, advisor, or supervisory personnel of the Greenwell Foundation and/or the Department of Natural Resources, to consent on my/our behalf, in our absence, to any emergency medical treatment which may be required for myself, or the Minor volunteer and do agree to indemnify and hold harmless anyone giving such consent. I acknowledge that we have been informed and understand the inherent risks related to volunteer opportunities offered by both the Greenwell Foundation and the DNR.*Please note: By entering my name in the field below, I acknowledge my email address will be added to the list of awesome people who receive the Greenwell Foundation's monthly newsletters. It's a great way to keep up with everything that goes on at Greenwell. If after receiving the first newsletter you decide you no longer wish to have it arrive in your in-box, simply click the Unsubscribe link. (But we hope you won't do that!) Thank you!*Date NameThis field is for validation purposes and should be left unchanged.