Cheryl Baker, CEO

Board of Directors:

Polly Beste, Chairman

Bernard Bujnowski, Vice Chairman

Adele E. Fagan, Secretary

Colleen Krcelich, Treasurer

Ronald F. Brubaker

Diane Cavanagh, Ed.D.

Mark Culp, P.E.,LEED A

Timothy J. Duckworth, Esq.

Janice M. Haley-Schwoyer

Kimberly Hirschman

Tina Kisela

Robert D. Makos

Lynne Paul

Elizabeth Scofield

524 Fehr Rd.

Nazareth, PA 18064

Tel. 610-365-2266 Fax 610-365-2263 www.equi-librium.org

2016

Dear Prospective Volunteer:

Thank you for your interest in becoming a volunteer with

Equi-librium. Volunteers are the backbone of our program.

Your help is most appreciated and valued.

Enclosed is a summary of the role of volunteers at Equi-

librium. Also included are Registration Forms for you to

complete before your training. If you are under 18 years of age,

a parent or guardian will need to sign. Please bring them with

you when you come to volunteer training.

As we are accredited by PATH International

(Professional Association of Therapeutic Horsemanship

International), all volunteers must attend our training class.

Times and dates for the trainings are enclosed. If you plan to

attend a training, please e-mail or call the office at

610-365-2266 to register. A Volunteer Guidebook will be given

to you at the training.

If you have any questions or need further information,

please do not hesitate to call. Thank you again for your interest.

We look forward to meeting you and having you as part of our

team.

Sincerely,

Yvonne Darlington

Volunteer Coordinator

Contact Information:

Yvonne Darlington, Volunteer Coordinator 610-365-2266

volunteercoordinator@equi-librium.org

Directions to Equi-librium:

524 Fehr Road, Nazareth, PA 18064

Directions from Rt 33 South (coming from Stroudsburg): Take Belfast exit ( first exit after Wind Gap), turn right at bottom

of the ramp onto Henry Road, follow till stop sign, turn left onto Jacobsburg Road, take 2nd right onto Rose Inn Ave (you

can see the farm on your right hand side), then the first right onto Fehr Road. Our driveway is the first one on the right

(about 5 minutes from the highway). Welcome to Equi-librium.

Directions from Rt 33 North (coming from Allentown/Bethlehem): Take Belfast exit, turn left at bottom of the ramp onto

Henry Road, follow till stop sign, turn left onto Jacobsburg Road, take 2nd right onto Rose Inn Ave (you can see the farm on

your right hand side), then the first right onto Fehr Road. Our driveway is the first one on the right (about 5 minutes from

the highway).

VOLUNTEERING FOR EQUI-LIBRIUM

Experience The Connection!

2016

“Volunteering at Equi-librium has given me so much more than I ever imagined. I have learned so much from helping the

riders. I have grown so much as a person because of my experience.” --- An Equi-librium Volunteer

Equi-librium is an equine assisted activities program for children, youth and adults with special needs. It is a

Premier Accredited Center of PATH Int’l (Professional Association for Therapeutic Horsemanship International). All

Equi-librium instructors are PATH certified.

Volunteers are the backbone of Equi-librium. Without their hard work and commitment, our mission – “to

empower individuals with special needs to reach their highest potential through horse-related activities and therapy” would

simply be a great idea, nothing more. The program volunteer is a key element in providing the rider with a safe, enjoyable

environment whereby she/he can learn. Volunteers find Equi-librium to be fun and exciting. Experiencing the connection

with the horse and participant is a special gift to oneself that is both challenging and rewarding.

Our therapeutic horsemanship center is located in Nazareth, PA and operates year-round, six days per week from

morning to evening. Our instructors and volunteers work together to carry out the Individual Program Plan (IPP) of each

participant, helping to maximize the progress that each can attain. Volunteers usually work as horse leaders or side helpers.

There are other volunteer opportunities as well.

VOLUNTEER OPPORTUNITIES:

Attending a General Orientation and Training Session is required prior to volunteering. The training session begins

with an overview of Equi-librium, who we serve, our programs, and our policies and procedures. Then trainees go to the

therapeutic horsemanship center and have an opportunity to practice side helping, learn about mounting/dismounting

techniques, and other procedures. For those with horse experience interested in becoming horse leaders, additional training

will be available. There are also other volunteer opportunities that are listed below:

Lesson Program – Volunteers assist by leading horses or walking beside riders (side helping) during classes. Horse leaders

come with an understanding of, and experience with horses. They assist in preparing horses for classes (groom and tack),

and are responsible for leading horses during class.

Side helpers do not need experience, and help the instructor to fulfill the participant’s goals by offering physical, cognitive

and emotional support. Lesson program volunteers should be willing to commit to coming the same day and time each

week, and must help one hour or more each week. Side helpers may also assist the participant in learning how to groom and

tack.

Cart/Carriage Driving Program – Volunteers attend the general volunteer orientation and training session, then attend a

training session with the driving instructor. Driving volunteers include horse handlers, and able-bodied whips.

Equine Program – Volunteers may work directly with the instructor or barn staff to help feed and care for the horses and

facility.

Office - Volunteers assists with word processing, data entry, photocopying, bulk mailings and other support tasks.

Facility/Farm – Volunteers help with general maintenance, repairs and improvements of the facility.

Special Events – Volunteers serve on event committees and assist on the day of the events and fundraisers that are held

throughout the year.

Special Skills – Volunteers who possess skills or professional/technical experience that may be needed such as

photography, graphic design, computer knowledge, carpentry, electrical work, etc. are encouraged to contact us.

No matter what your skills or talents may be, there’s a place and a need for them at Equi-librium.

VOLUNTEER TRAINING: The success of Equi-librium depends on the commitment of well trained and knowledgeable volunteers. Volunteer training

is required by the program standards of our PATH Accreditation. All new volunteers must take a Volunteer Training

Program before participating. Volunteers need to be a minimum of 14 years of age. It is very important that once you take

the training that you commit to volunteering. Our programs cannot operate without volunteers. As a volunteer you are

integral to the success and achievements of our participants with disabilities. Only one afternoon of training is required but

both parts must be attended. Please e-mail the office to register for training. There are also opportunities for continuing

education which will be outlined at the training.

PROGRAM DATES & TIMES:

Equi-librium operates program year round in four ten week sessions, covering the spring, summer, fall and winter.

Volunteers can sign up for one or more ten week sessions. Day and evening times are available 6 days per week. Volunteers

choose what day or night and the times they are able to help. Program lessons run for 45 minutes. We need anywhere from

8 to 12 volunteers per lesson. Volunteers are required to sign up for 1 or more hours a week for the same day and time each

week. Many volunteers come for two or more hours on more than one day.

Equi-librium Volunteer Training Dates:

Saturday: March 12th and 19th, April 9th, May 14th, June 11th, July 9th, August 13th,

September 10th, October 15th.

Training Times:

12:30pm – 1:30pm Part 1: Introduction to Equine Assisted Activities and Equi-librium

1:45pm - 3:30pm Part 2: Hands on practice with the horses

Contact Information:

Yvonne Darlington, Volunteer Coordinator 610-365-2266

volunteercoordinator@equi-librium.org

Directions to Equi-librium:

524 Fehr Road, Nazareth, PA 18064

Directions from Rt 33 South (coming from Stroudsburg): Take Belfast exit ( first exit after Wind Gap), turn right at bottom

of the ramp onto Henry Road, follow till stop sign, turn left onto Jacobsburg Road, take 2nd right onto Rose Inn Ave (you

can see the farm on your right hand side), then the first right onto Fehr Road. Our driveway is the first one on the right

(about 5 minutes from the highway). Welcome to Equi-librium.

Directions from Rt 33 North (coming from Allentown/Bethlehem): Take Belfast exit, turn left at bottom of the ramp onto

Henry Road, follow till stop sign, turn left onto Jacobsburg Road, take 2nd right onto Rose Inn Ave (you can see the farm on

your right hand side), then the first right onto Fehr Road. Our driveway is the first one on the right (about 5 minutes from

the highway).

EQUI-LIBRIUM, Inc. 610-365-2266 (Admin. Office)

524 Fehr Road 610-365-2263 (Fax)

Nazareth, Pa 18064 e-mail: volunteercoordinator@equi-librium.org

VOLUNTEER APPLICATION/REGISTRATION

Name: ______________________________________________ Date of Birth: ________________

Address:__________________________________________________________________________

City/Town:_____________________________ State:___ Zip:________ County:________________

Best Time to Contact You: _______________________ Where: _____________________________

Phones: Home: _________________________ Work: ________________________________

Cell: ___________________________ Fax: _________________________________

Email: __________________________________________________________________

Occupation: _______________________ Employer: _______________________________________

Does your employer have a matching gift program? __Yes__No

If Student, name of school and school district:________________________________________

Name(s) of Parent(s) or Legal Guardian:___________________________________________

Address: (If different than above)_________________________________________________

Phone Number: (If different than above)___________________________________________

Primary Language (English, Spanish, French, etc.):___________________________________

Work experiences: _____________________________________________________________

Volunteer experiences: __________________________________________________________

How did you hear of Equi-librium? __________________________________________________

Do you have any significant medical problems? (e.g. diabetes, cardiac, respiratory, allergies?)

_____Yes _____No If so specify__________________________________________________

Do you have any significant physical limitations? _____Yes _____No If so, specify: __________

_____________________________________________________________________________

Can you walk 45 minutes and jog for short distances? ______Yes _____No

Can you hold your arm above shoulder height and support a modest weight? _____Yes _____No

Are you certified in CPR? ______ No _____ Yes Expiration Date _______________

Are you certified in First Aid? _______ No _____ Yes Expiration Date ____________

Do you know sign language? _______No_____ Yes

Check areas you are interested in: Leading a Horse In-House Horse Show Newsletter/Website □ Office Work

Side helping with a rider Away Horse Shows Volunteer Recruitment Gardens & Grounds

Stable Management Summer Camp Photography/Video Board Service

Equipment Maintenance Fund Raising Public Relations Special Events

EQUI-LIBRIUM, Inc. 610-365-2266 (Admin. Office) Therapeutic Horsemanship 610-365-2263 (Fax) 524 Fehr Road e-mail: volunteercoordinator@equi-librium.org Nazareth, Pa 18064

Volunteer Authorization

for Emergency Medical Treatment

Please read and sign one of the Consent Plans below

Volunteer’s Name: _________________________Phone: ___ ____________

Address: ____________________________________________________________

Contact to Notify in the Event of an Emergency: Contact_______________________________________ Phone_____________ Contact_______________________________________ Phone_____________

CONSENT PLAN for Medical Treatment

In the event emergency medical aid/treatment is required due to illness or injury during the process of receiving services, or while being on the property of the agency or program site,

I authorize Equi-librium to:

1. Secure and retain medical treatment and transportation if needed.

2. Release Volunteer records upon request to the authorized individual or agency involved in the

medical emergency treatment.

Physician’s Name:_________________________________________________________________

Physician Address:___________________________________Phone:________________________

Preferred Medical Facility: ___________________________________________________________

Health Insurance Co.:_________________________________ Policy #:_______________________

This authorization 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 above is unable to be

reached.

Date:______________ Print Name: _______________________________________________

Consent Signature:____________________________________________________________

Volunteer or Parent/Legal Guardian if under 18

NON-CONSENT PLAN for Medical Treatment

I do not give my consent for emergency medical treatment/aid in the case of illness or injury during the

process of receiving services or while being on the property of the agency or program site. In the event

emergency treatment/aid is required, I wish the following procedures to take place:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________

Date:_____________ Print Name: _______________________________________________

Non-Consent Signature:_______________________________________

Volunteer or Parent/Legal Guardian if under 18

Equi-librium, Inc.

524 Fehr Road, Nazareth, PA 18064 610-365-2266 (Ph), 610-365-2263(Fax)

VOLUNTEER

ACKNOWLEDGEMENT OF RISK ACCEPTANCE OF RESPONSIBILITY, RELEASE OF LIABILITY AND INDEMNIFICATION

I, the undersigned, hereby acknowledge that I have voluntarily applied to have myself or my son/ my daughter/ my ward engage in equine-assisted and other volunteer activities that include horseback riding with Equi-librium, Inc. I, represent that I am, or my son/ my daughter/ my ward is in good health and do not have any physical limitations that could affect my/their ability to engage in the equine-assisted and other volunteer activities. I agree to participate in the equine-assisted and other volunteer activities without benefit or compensation. I understand the activity of horseback riding, all equine-assisted and other volunteer activities involve numerous inherent risks of injury that are an integral part of such an activity. I knowingly and freely assume full responsibility for myself or for my son/ my daughter/ my ward for all such risks, known or unknown, whatever the cause, even if arising from the negligence of Releases (as hereinafter defined), or others. I and/or my family further understand that an animal, irrespective of its training and usual past behavior and characteristics, may act or react unexpectedly or unpredictably at times, and I also assume such risks for myself, my son/ my daughter/ my ward. As consideration for being permitted by Equi-librium, Inc. to engage in equine-assisted and other volunteer activities including horseback riding, I for myself and on behalf of my heirs, successors, assigns, personal representatives, executors and next of kin, do hereby waive any claim, release, indemnify and hold harmless Equi-librium, Inc. and all of the officers, members, affiliated organizations, agents and/or employees, other participants, successors, assigns, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessors of the premises used for the equine-assisted and other volunteer activities (“Releasees”), with respect to any and all injury, disability, death, or loss or damage to person or property associated with my presence or my participation in equine-assisted or other volunteer activities including horseback riding whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law. This contract shall be legally binding upon me, my heirs, my estate, assigns, legal guardians, and my personal representatives. On February 21, 2006, Pennsylvania’s Equine Activity Act went into effect. This act applies to an individual, group, club or business entity that sponsors, organizes, conducts or provides the facilities for an equine activity where a sign indicating that “You assume the risk of equine activities pursuant to Pennsylvania law.” This sign is conspicuously posted at the Equi-librium Equine Activities Center, 524 Fehr Road, Nazareth, PA. I have carefully read this agreement and fully understand the contents. I am aware that I am releasing certain legal rights that I otherwise may have, and I enter into the contract in behalf of myself and/or my family of my own free will.

Name of Volunteer: _______________________________________________

Signature of Volunteer: ________________________________________________ (18 or over only)

FOR PARENTS/GUARDIANS OF MINOR (UNDER 18) OR INCAPACITATED PARTICIPANT SEE NEXT PAGE

FOR PARENTS/GUARDIANS OF MINOR (UNDER 18) OR INCAPACITATED VOLUNTEER

This is to certify that I, as parent/guardian with legal responsibilities for this volunteer, do consent and agree to his/her release as provided above of all Releasees, and, for myself, my child/ward, and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s/ my ward’s engagement or participation in the activities as provided above, even if arising from the negligence of the Releasees, to the fullest extent permitted by law.

Mother’s Signature_______________________________________ Date: ______________ Father’s Signature _______________________________________Date: ______________ Legal Guardian _________________________________________Date: ______________

Please Note: The person or persons having legal custody of the participant must sign this form. In cases of joint or shared custody both persons must sign this form.

Child Protection Law Changes

Any adult volunteer (18 and older) who is responsible for the welfare of children or has direct

contact with children must obtain criminal background checks and child abuse clearances.

These checks must be renewed every 3 years, and the requirement goes into effect July 1, 2015.

Criminal record checks can be completed at: https://epatch.state.pa.us

This clearance will take about two weeks to process.

PA Child Abuse History Clearance can be completed at: www.dhs.state.pa.us

This clearance will take about four weeks to process.

Both these checks will cost a small fee for which we cannot reimburse you. We need a copy of

the clearances (you can keep the originals) and we accept all copies that are no more than 3 years

old. You can start volunteering as soon as we receive both your copies.

We will have paper forms available at the office at Equi-librium if you prefer to do it non-

electronically.

All volunteers please complete the Disclosure Statement on the next page

Volunteer Disclosure Statement (Required by Child Protective Services Law, 11 P.S. s2223.1(0)

I swear/affirm that I have not been named as a perpetrator of a founded report of child abuse as defined by the

Child Protective Services Law within the preceding five years in any state.

I swear/affirm that I have not been convicted of one or more of the following crimes under Title 18 of the

Pennsylvania Consolidated Statutes or equivalent crime in another state within the preceding five years:

Chapter 25 (relating to criminal homicide)

Section 2702 (relating to aggravated assault)

Section 2901 (relating to kidnapping)

Section 2902 (relating to unlawful restraint)

Section 3121 (relating to rape)

Section 3122 (relating to statutory rape)

Section 3123 (relating to involuntary deviate sexual intercourse)

Section 3126 (relating to indecent assault)

Section 3127 (relating to indecent exposure)

Section 4303 (relating to concealing death of a child born out of wedlock)

Section 4304 (relating to endangering welfare of children)

Section 4305 (relating to dealing in infant children)-

A felony under

Section 5902(b) (relating to prostitution and related offenses)

Section 5903(c)

Or (d) (relating to obscene and other sexual materials)

Section 6301 (relating to corruption of minors)

Section 6312 (relating to sexual abuse of children)

I understand that I must be dismissed if I have been named as a perpetrator of a founded report of child abuse or

have been convicted of any of the crimes listed above within the past five years.

I understand that my service as a volunteer may be terminated if I have been named as the perpetrator of a

founded report of child abuse longer than five years ago, the perpetrator of an indicated report of child abuse, or

convicted of any of the crimes listed above longer than five years ago.

I hereby swear/affirm that the information as set forth above is true and correct. I understand that the penalty for

false swearing is a misdemeanor of the third degree pursuant to Section 4903(b) of the Crimes Code.

Print Name: ______________________________

Signature: _______________________________

Parent/Guardian Signature if under 18 years of age: ____________________________________

Date: ________________________________

Equi-librium, Inc. 524 Fehr Road, Nazareth, PA 18064

610-365-2266 (Ph), 610-365-2263(Fax)

MEDIA RELEASE

VOLUNTEER Our Equi-librium participants, families and volunteers are our best advocates! We occasionally have the opportunity to feature one of our Equi-librium children or adult participants or volunteers in the media, including printed material, television, newspaper, radio or the Internet, to promote Equi-librium programs and services.

Please indicate your Media Consent or Non-Consent Below

CONSENT: □ Please check box

I hereby grant permission for Equi-librium, Inc. to use photographs, videos, quotes, or information regarding:

_________________________________________________ for Equi-librium promotional purposes.

(Name of Volunteer- Print)

NON-CONSENT: □ Please check box

I do not grant permission for Equi-librium, Inc. to use photographs, videos, quotes or information regarding:

_______________________________________________ for Equi-librium promotional purposes.

(Name of Volunteer – Print)

Signature of Volunteer (18 or over only):____________________

Signature of Parent(s)/Guardian ______________________________________________ (If Volunteer is under 18) (Mother’s Signature) ______________________________________________ (Father’s Signature) ______________________________________________ (Legal Guardian)

______________________________________________ (Date)

Please Note: The person or persons having legal custody of the participant must sign this form. In cases of

joint or shared custody both persons must sign the form.

Volunteer Availability Form (You may fill this out and return it if you know your available times or wait until day you receive training.

Availability must be determined on the day of training.)

Name _____________________________________________________

Best Phone Number: _________________________________________

Please write down all of you available times, then circle or star your first preference.

___ Monday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm ___4pm

Evening: ___5pm ___6pm ___7pm

___ Tuesday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm ___4pm

Evening: ___5pm ___6pm ___7pm

___ Wednesday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm ___4pm

Evening: ___ 5pm ___6pm ___7pm

___ Thursday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm ___4pm

Evening: ___5pm ___6pm ___7pm

___ Friday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm ___4pm

Evening: ___ 5pm ___6pm ___7pm

___ Saturday Morning: ___9am ___10am ___11am ___Noon

Afternoon: ___1pm ___2pm ___3pm

Months Available: ___January ___February ____March ____April

____May ____June ____July ___August ___September ____October

____ November ____December

Horse Experience: ___Beginner ___Novice ___ Intermediate ____Advanced

____None, but would like to learn. Tell us about your horse experience:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

I am interested in the Horse Handler Track: _______

I am interested in the Participant/Special Needs Track: _______

Thank you for your willingness

to support us as a volunteer –

we depend on you!