Volunteer — Blue Apple Ranch

Thank you for your interest

We welcome new volunteers, please fill out the form below.

If you prefer to mail in your application please download the Volunteer Application, complete it and mail it back to: P.O. Box 519 Poway, CA 92074, fax it to (858) 391-2980, or email it to info@blueAppleranch.org.

General Information

Full Name *
Date *
Phone (Primary) *
Phone (Secondary)
Email *
Date of Birth *
We celebrate birthdays, do you? *
YesNo
Employer/School
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Emergency Contact *
Relationship *
Phone Number *
Parent/Legal Guardian/Caregiver Name /Address/Phone Number (if under 18) *
If you are over 18 please enter your age into this box. This form will not submit without an entry.
How did you learn about the program?

Name of Insurance Provider
Name Insured
Policy Group or ID Number
Emergency Contact (Name and Number)
Does the Blue Apple Ranch have permission to contact this person
YesNo
Last Tetanus Shot
Tuberculosis Test (+/ -) Date

At the Blue Apple Ranch we provide a "Level Program" to best describe the experience of each new volunteer entering our program. To the best of your ability please check the level that you feel best fits your experience
Level One: Basic knowledge of horses (no handling or riding experience)Level Two: Knowledge of horse behavior and their history (beginning experience with ground work and riding)Level Three: Grooming knowledge and how to applyLevel Four: Knowledge of detailed horse and stable environment safety (this level is for individuals that have an intermediate riding and ground experience with horses),Level Five: Extensive horse handling knowledge. This level is for individuals that have had a minimum of three years with horses

Health History
Describe your current health status, particularly regarding the physical/emotional demands of working in an equine assisted program. Address fitness, cardiac, respiratory, bone or joint function, recent hospitalizations/surgeries, or lifestyle changes.
Allergies
Medications

Hello, having fun yet?

We know this form is long.
If you prefer to mail in your application please download the Volunteer Application, complete it and mail it back to: P.O. Box 519 Poway, CA 92074, fax it to (858) 391-2980, or email it to info@blueAppleranch.org. Or else please continue, your application will reach us much faster this way.

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.
Electronic Signature *
YesNo
Date *
I have received, read, understand, and will abide by the Safety Regulations and Emergency Procedures Blue Apple Ranch provided.
Electronic Signature *
YesNo
Date
I consent to and authorize the use and reproduction by Blue Apple Ranch of any and all photographs and any other audio/visual materials taken of me for promotional material, educational activities, and exhibitions Or for any other use for the benefit of the center.
Electronic Signature *
YesNo
Date *

Background Information

Have you ever been charged with or convicted of a crime? *
YesNo
Please Explain
Are you currently out on bail or on your own recognizance pending trial for a prior arrest *
YesNo
I, ___________________________________ (enter below), authorize Blue Apple Ranch to receive information from any law enforcement agency, including 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 convictions I may have had for violations of state or federal criminal laws, including but not limited to convictions for crimes committed upon children or animals. I understand that such access is for the purpose of considering my application as an employee/volunteer, and that I expressly DO NOT authorize Blue Apple Ranch, its directors, officers, employees, or other volunteers to disseminate this information in any way to any other individual, group, agency, organization, or corporation.
Volunteer Name *
Date *
Current Driver’s License Number
State

Confidentiality Agreement

I understand that all information (written and verbal) about participants at Blue Apple Ranch is confidential and will not be shared with anyone without the expressed written consent of the participant and their parent/guardian in the case of a minor.
Electronic Signature *
YesNo
Date *
Waiver of Liability I_______________________________________ (enter below) the undersigned, accept as a condition of both my invitation and presence on the property located at 15444 Mussey Grade Road Ramona, CA 92065-known as Blue Apple Ranch, release any and all liabilities, risks and potential injuries relative to my visit. The waiver of any and all such liabilities includes the owners of the property as well as the employees and officers of the board of directors of the Toby Wells Foundation. All risks are assumed including damage to personal property or physical injuries from whatever source.
Volunteer Name *
Date *

Verification

Prove you are not a robot *Example: 42
This box is for spam protection - please leave it blank: