Volunteer Application Form

Scropton Horse Centre

Home of Scropton Riding for the Disabled

Registered Charity No 1170646
Volunteer Application Form
If you are under 18 or someone else normally completes your paperwork for you, this form should be completed and signed on your behalf by your parent or legal guardian.

A DBS (Disclosure Barring Service) check will be required for all volunteers over the age of 16.

All information will remain confidential for use by centre personnel only.

This application form needs to be completed in one sitting so please make sure you have the following information to hand so that you can complete it in full:
- Personal and contact details
- Details of any previous relevant experience
- If joining as part of a school or training centre, or through a referral from a Council Social Care, Education or Health Department, a contact name/ contact details are needed
- Health Information including details about medical practitioners and medications
- Two emergency contact names & phone numbers
- Names & contact details of two people who can provide references
- For anyone signing on behalf of a participant other than a parent, you will need to upload documentation to show that you have the authority to sign on the participants behalf
Please note you must be 12 or over to apply to be a volunteer.
YOUR DETAILS
First Name*
Middle Name
Last Name*
Preferred Name if different
Date of Birth*

DayMonthYear
Date
Address
First line of address
Second line of address
Town/City
County
Postcode
Email*
example@example.com
Mobile Phone Number
Please enter a valid phone number.
Landline Phone Number
Please enter a valid phone number.
If you are volunteering to help a participant in your family group / bubble only, please give the name of that participant here:

EXPERIENCE
Do you have equine experience in riding and horse care?
Do you have experience of working with people with additional special needs?
Please let us know about any other professional skills or qualifications you may have:

APPLYING THROUGH ANOTHER ORGANISATION
If you are applying for work experience or to volunteer through a school or training centre, or through a referral from a Council Social Care, Education or Health Department, please fill in the details below.

You do not need to provide this information if you are applying independently to volunteer.
School/Department/Centre Name
School/Department/Centre Contact Name
Phone Number
Please enter a valid phone number.
Email
example@example.com

Please tell us about any diagnosis, disability, difficulty, condition or allergy that may affect the level of support you need to safely participate in activities. Please include any medication taken and potential side effects.
If you are under the care of a doctor for any of the above, please give their name and contact details:
What, if any, conditions or concerns do you have that may need special attention during activities with horses? It is the applicant's responsibility to ensure that we have knowledge of all issues that may pose a problem.
Please provide the name and contact details of a health-care or other professional (eg Physiotherapist, Occupational Therapist, Social Worker or Psychotherapist) who knows you and your health and/or learning needs.
Do you have any specific language needs? (ie nonverbal, BSL, Makaton)
Please provide any other information that would be useful:

EMERGENCY CONTACTS
Please provide details of 2 people who can be contacted in the case of an emergency
Emergency Contact 1
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Emergency contact 2
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.

REFERENCES

All volunteers are asked to provide two references to support their application. These people should not be related to you and where possible should be someone who knows you in a professional capacity.
Reference 1
Name

First NameLast Name
Address
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Relationship to applicant
Reference 2
Name

First NameLast Name
Address
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Relationship to applicant

DECLARATION AND SIGNATURE OF ACCEPTANCE
Please ensure that you read and sign to accept all of the following:

1. I wish to apply as a volunteer at the centre and confirm that all details given are accurate to the best of my knowledge. I agree that should the centre require additional information about me at any time, I will provide what is required. If required, I am willing to obtain reports from a specialist practitioner who is familiar with my condition and understand that I may be required to pay a fee for such a report.

2. I recognise that activities with horses are a risk sport and I voluntarily accept the risks involved. I further understand the need for the participant or carer to take all reasonable precautions. In the absence of any negligence on the part of the centre, I accept that no liability will attach to them.

3. I will immediately inform the centre of any change in my:
- address, email or contact numbers
- medication or in my mental or physical health condition
- changes to my emergency contact details

4. Volunteers working with horses need to provide their own riding hat that conforms to valid safety standards (Standards currently include PAS015:1994 or PAS015:1998, ASTM F1163 (2004a), SNELL E2001 or VG1). We have a small number of hats that may be borrowed for initial sessions, but regular volunteers will need their own hat.

6. If I engage in any behaviour that falls outside the Scropton Behaviour Agreement, this may result in immediate termination of my sessions without notice.

7. I agree to taking all measures necessary to minimise the risk of the spread of the Covid-19:

- I will ensure before each visit to the group, that I am not displaying any COVID-19 symptoms requiring self-isolation i.e. high temperature, a new persistent cough or loss of smell or taste; or living with anyone who is displaying any of these symptoms.

- If symptoms are evident, for me or anyone in my household, I will contact the Group to let them know and I will stay at home in line with government guidelines.

- I will thoroughly wash or sanitise my hands on arrival.

- I will endeavour to follow standard social distancing at all times possible i.e. remain at 2m/6ft distance from others (other than my parents/carers, when applicable).

- If I fall ill, or display any of the symptoms during my visit, I will advise somebody then return home immediately, avoiding touching anything where possible and follow advice on self-isolation.

In preparation of getting started after lockdown, our centre has taken the following measures necessary to minimise the risk of the spread of the infection:

- Ensured the venue has been cleaned, with all hard surfaces and equipment sanitised.

- Displayed signs on site to remind everyone of the need for social distancing and thorough hygiene regimes.

- Supplied sufficient soap/sanitising products and disposable hand towels to allow regular hand washing.

By returning to our centre and signing this form I am confirming that I do not need to self-isolate and acknowledge the Scropton RDA has taken all reasonable steps to reduce the risks of COVID-19.
I have read and agree to these terms and conditions*

YesNo
Signature (This must be signed by a parent/legal guardian if the applicant is under 18 years old or where another party is responsible for their legal affairs)*

Clear
Name of signatory*

First NameLast Name
Relationship to applicant (if signing on their behalf)
Position if signed by School/Department/Centre representative
For anyone signing on behalf of a participant other than a parent, please upload documentation to show that you have the authority to sign on the participants behalf

Cancelof
Please use this space to add any other comments or messages to accompany your application form:
Should be Empty:

Scropton Horse Centre

Home of Scropton Riding for the Disabled

Volunteer Application Form

YOUR DETAILS

Address

VOLUNTEERING

EXPERIENCE

APPLYING THROUGH ANOTHER ORGANISATION

INFORMATION ABOUT YOU

Speech

Eyesight

Hearing

Mental Health

Learning Disability

Behaviour

Instructions

Walking

EMERGENCY CONTACTS

Emergency Contact 1

Emergency contact 2

REFERENCES

Reference 1

Reference 2

CONSENT

Photographs

First Aid

Behaviour Code

Data protection

Communication

Membership Association

DECLARATION AND SIGNATURE OF ACCEPTANCE