Emergency Contact Person*
Please provide your drivers licence number, State of issuance and expiration date.*
Do you have roadside assistance insurance?
Do you have medical insurance that will cover medical expenses in case of an accident?
Your electronic signature certifies that the information entered on this form is true.
Volunteer driver has a valid driver's license. Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to SWAT.
Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Saving Whiskers and Tails and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature,either in law or in equity, which arise or may hereafter arise from the services I provide to Saving Whiskers and Tails. I understand and acknowledge that this Release discharges SWAT from any liability or claim that I may have against SWAT with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to SWAT or occurring while I am providing transport services.*
Partners in rescue: