Returning Volunteer Annual Paperwork



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Medical Information


Emergency Contact #1




Emergency Contact #2




Medical Consent Plan

Please sign (or have a parent/guardian sign if you are under 18) either the consent or non-consent plan.

In the event of an emergency, if medical aid/treatment is required due to illness or injury during the process of volunteering, or while being on the property of the agency, I authorize Heartland Equine Therapeutic Riding Academy to secure and retain medical treatment and transportation if needed.  This authorization also includes x-ray, surgery, hospitalization, medication and any treatment procedure deemed "life-saving" by the physician.  This provision will only be invoked if the person listed below or the emergency contact person is not able to be reached.  By putting your name in the box below you are consenting to the above statement.




Liability Release

As a volunteer at Heartland Equine Therapeutic Riding Academy, I acknowledge the risks and potential for risks of a horseback riding program. However, I feel that the possible benefits to myself and the clients I work with are greater than the risk assumed. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Heartland Equine Therapeutic Riding Academy, its board of directors, instructors, therapists, volunteers and employees for any and all injuries and/or losses I may sustain while participating Heartland Equine Therapeutic Riding Academy’s program.

 

WARNING 

Under Nebraska Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to sections 25-21,249 to 25-21,253.

 

By putting your name in the box below you are consenting to the above statement.




Confidentiality Agreement/Policy

I understand that that Confidentiality is essential regarding all aspects of this program. Please respect the dignity and privacy of our clients and their families. I agree to keep student’s name, age, diagnosis and any other medical or personal information confidential.

By putting your name in the box below you are consenting to the above statement.




Photo Release






Social Media Policy
Heartland Equine Therapeutic Riding Academy (HETRA) embraces social media and relies on our staff and volunteers to increase our online presence and build our brand. It is one of the most powerful platforms we have to share our mission, create positive awareness for our organization, and engage with our community on a daily basis. We highly encourage our staff and volunteers to engage with HETRA’s social platforms by liking, commenting, and sharing our posts.

**HETRA Videos and Photography**
Due to the sensitive and personal nature of our participants and the services we offer, we must exercise every precaution to protect our privacy and confidentiality policies. ONLY HETRA STAFF MEMBERS  ARE AUTHORIZED TO TAKE PHOTOS/VIDEO OF ANY HETRA PERTICIPANT, VOLUNTEER, THE HETRA FACILITY, HORSE OR EMPLOYEE.  If you would like a photo/video taken, please ask one of our staff members.  Photos/videos may only be taken on the staff member's phone or other HETRA authorized equipment.  All photos/videos will be submitted to our photo/video committee for approval.  Once approved, the photo/video will be provided to the requester along with permission to post/use it.  

Where to find HETRA:

Facebook            TeamHETRA                                                     
Twitter                @HETRA            
Snapchat            Team HETRA
Instagram           team_HETRA
You Tube            HETRANebraska             
Linked In            HETRA

ALWAYS:
  • Help HETRA spread the good word - share, retweet, and regram HETRA posts on your own social platforms. 
  • Follow the HETRA confidentiality policy
  • Refer to HETRA horses in a positive manner and forward inquiries about HETRA horses to a staff member
  • Think twice before posting. If you have any doubt, please do not post.

NEVER:
  • Claim to be an official representative of HETRA
  • Share confidential information about a participant, volunteer, employee or the organization
  • Take photographs or video of a HETRA participant, volunteer, horse or employee unless specifically requested to by a designated staff member
  • Use language that is profane, harassing, racial, political, religious, or that is considered biased or slurred when posting about HETRA.
  • Refer to a HETRA horse or the HETRA barn environment negatively.

Violation of Social Media Policy

If a social media post is discovered that is in violation of this policy, you will be asked by a staff member to remove the post. Failure to remove a post could result in verbal or written warning or immediate dismissal from the HETRA facility and program.



COVID-19 ACKNOWLEDGEMENT OF RISK AND ACCEPTANCE OF SERVICES
AS OF MAY 11, 2020 - REQUIRED FOR ALL STAFF, CONTRACTORS, VOLUNTEERS, PARTICIPANTS, PARTICIPANT CAREGIVERS AND FAMILY AS WELL AS ANY GUESTS TO THE HETRA FACILITY.

I am aware of the risks of contracting or spreading Covid-19 while working or volunteering at Heartland Equine Therapeutic Riding Academy; attending an event; and/or receiving on site services from Heartland Equine Therapeutic Riding Academy during the time of a pandemic outbreak. 

I am aware that on site services and experiences may increase my risk of contracting and passing on the Covid-19 or Coronavirus and agree to hold harmless Heartland Equine Therapeutic Riding Academy and its Board of Directors, staff, Medical Advisor Board, members, officers, managers, agents, employees, volunteers and all other individuals I may come in contact with during this interaction and receiving of services, providing services, attending an event, volunteering within this organization or visiting. 

I agree to and will follow all guidelines for personal hygiene, personal safety and public safety as recommended by Heartland Equine Therapeutic Riding Academy; as well as my individual provider/practitioner. This may include, but is not limited to, maintaining social distance; limiting the number of people attending with me to what is outlined by the organization at the time, washing my hands prior to and following each session or activity; use of hand sanitizer upon request; wiping down surfaces with disinfecting wipes and/or wearing a mask and/or gloves. 

I agree to stay home and/or cancel my time at Heartland Equine Therapeutic Riding Academy should I have personally exhibited or have been in contact with someone who has presented with illness within the previous 24 hours to 2 weeks, including; cough, sneezing, fever, chest congestion or additional signs of potential spread of any virus or bacteria/disease. In addition, I will follow the recommendations of my provider once I have notified them of these risks in regards to my future services or attendance during this pandemic.

Heartland Equine Therapeutic Riding Academy will engage in regular cleaning and sanitizing of the facility, horse tack, equipment, doors, and frequently touched areas in-between participants and on a daily basis as recommended by the CDC for the safety of participants, their families, employees, volunteers and horses. 

I am signing under my own free will and agree to follow these and hold harmless all individuals associated with Heartland Equine Therapeutic Riding Academy

BY SIGNING BELOW, I CONFIRM THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT.

*In the event that the undersigned is under the age of 19, the signature of a parent or guardian is required.



Barn Rules

1. Please DO NOT pet the horses in any outside pens or indoor stalls. Some horses on the property are privately owned and are not part of the HETRA herd.


2. Please do not arrive at the barn before you are scheduled, there must be a HETRA Instructor, Staff Member, or Barn Leader on site when volunteers, students or guests arrive. For insurance purposes there cannot be visitors at the HETRA facility when there is not a staff member on site.


3. ONLY the Barn Leader or approved Horse Leader will be allowed to get horses from outside pens.


4.  No untrained individual should enter a pen or stall with a loose horse in it. 


5. You should not be in any outside pen UNLESS you have been asked by an Instructor or Barn Leader to complete a specific task in this area.  Once this has been completed please return to the proper volunteer areas.


6. NEVER sit, kneel or lay on the ground near a horse.


7. All phones must be turned to silent or vibrate when in the arena - NEVER answer your phone while working in the arena.


8. Please only use HETRA tack and equipment and always return it to its appropriate place.


9. Always clean up after yourself and any horse you are working with (sweep up any hair, manure, and throw away any trash).


10. All riders during a HETRA riding session are required to wear approved safety helmets (this includes Instructors).


11. Please do not feed any horses treats. Treating horses tends to promote biting.  Also some of the horses are on special diets and treats can be detrimental to their health. Please do not allow the horses to lick your hands this encourages biting. 


12.  Please DO NOT pet the horses on their heads or faces, this is a personal space for them and can make them crabby.


13. When approaching a horse, always consider the horse’s limited field of vision. Horses cannot see directly behind or in front of them without moving their head. Always approach a horse at the shoulder, speak to them as you approach, and then extend your hand and pat them on the neck or shoulder. When moving around a horse, placing a hand on their hip as you move around them allows them to know where you are.


14. Avoid sudden movements when around the horse. This includes removing coats, raising arms suddenly, running, jumping climbing, etc. Horses can spook easily, please keep this in mind at all times when around horses.


15. Please Do NOT reach into or pet a horse through the bars. If they can put their heads out it is ok to pet them.  Please respect that they may need down time and do not want to be petted.


16. Only HETRA Instructors are allowed to put on or remove the bridles on the HETRA horses.


17. Please do not bring dogs or any other animals to the barn. (If you have a service animal please notify HETRA Staff).


18. The cats are cute and fun to play with but they can bite and scratch. Playing with the cats is done at your own risk. Please monitor any children during their interaction with the cats.


19. All children under the age of 12 must be DIRECTLY monitored by an adult at all times while on the property.


20. DO NOT enter any other buildings on the property unless directed by a HETRA Instructor or Staff Member.


21. If you are not directly involved with a session please keep all activities and conversations to the designated waiting areas or check with the Barn Leader Instructor as to additional tasks that need to be done around the barn. It is important to keep noise and conversation to a minimum when lessons are being conducted as it can be very distracting for the students and horses.


22. The session Instructors are ultimately responsible for all aspects of the session from the time the first horse is taken out until the last one is put away. Please listen and follow all directions given by the session Instructors. Please be aware of all situations around you and report any unsafe situation to the session Instructor or Barn Leader immediately.


23.  HETRA strictly prohibits anyone, including individuals with permits, to carry concealed handguns, from possessing and/or carrying a concealed handgun while on HETRA's property.  NO EXCEPTIONS will be made to this Policy.  Any violation may result in the dismissal of Volunteer or Guest.


24.  HETRA is a Tobacco Free Facility.  Smoking or the use of any tobacco products is strictly prohibited on the HETRA property.  This includes the arena/barn area as well as the parking lot and adjacent buildings on the property.


HETRA does not discriminate on the basis of race, color, religion, national origin, gender, age, or disability in admission to it's programs, services, or activities, or any other aspect of their operations.


HETRA Volunteer & Guest Dismissal Policy: HETRA reserves the right to dismiss a guest or volunteer from the facility and from the program if their behavior is putting themselves, a participant, staff, other volunteers or the horse’s mental or physical health in jeopardy. The HETRA instructor in charge at the time of the incident will review the behavior with the volunteer and determine the level of intervention necessary. The level of intervention could include a verbal or written warning or immediate dismissal from the HETRA facility and program. Physical, emotional, mental or sexual abuse by a person at the HETRA facility will not be tolerated and will result in immediate dismissal from the HETRA facility. Alcohol consumption by a volunteer prior to a session is not allowed. A volunteer smelling of alcohol will not be allowed to assist with that night’s session.


These rules are in place for everyone’s safety. Please follow these rules at all times while at the facility.Anyone not following these rules will be asked to leave the facility.


My Family and/or I have read the barn rules and agree to follow them at all times while at the facility.


By putting your name in the box below you are consenting to the above statement.