Wild Rescuevolunteer Programme

WILD RESCUEVOLUNTEER PROGRAMME

Application Form

Please e-mail back to

1. Dates for Volunteering: …………………………. - ………………………….

1. Costs of Volunteering

Cost per 1 week (food and shared accommodation included) as at November 2016
R. South African / € European +- / £ UK +- / $ USA +-
Less than 3 weeks / 5,000 / 325 / 290 / 360
3 – 6 weeks / 4500 / 290 / 260 / 325
7 – 12 weeks / 4000 / 260 / 230 / 290
More than 3 months / On application

1. Personal Details:

Surname:……………………………………………………………………………….

First Names:……………………………………………………………………………….

Date of Birth (dd/mm/yyyy): ……………………………………………………………………………….

Age:……………………………………………………………………………….

Gender:……………………………………………………………………………….

Mobile Telephone No:……………………………………………………………………………….

Alternative Telephone No:……………………………………………………………………………….

Mobile Tel. No. while in SA: ……………………………………………………………………………..

(Please inform Wild Rescue staff if it changes from previous number)

E-mail address:……………………………………………………………………………….

Nationality:……………………………………………………………………………….

Passport number:……………………………………………………………………………….

(or ID No. if SA citizen)

Language (s) spoken:……………………………………………………………………………….

Residential Address:……………………………………………………………………………….

……………………………………………………………………………….

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Postal Address (if different from above): …………………………………………………………….

……………………………………………………………………………….

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1. Next of Kin 1:

Full name:……………………………………………………………………………….

Relationship:……………………………………………………………………………….

Town and Country:……………………………………………………………………………….

Contact number(s):……………………………………………………………………………….

Next of Kin/Contact 2:

Full name:……………………………………………………………………………….

Relationship:……………………………………………………………………………….

Town and Country:……………………………………………………………………………….

Contact number(s):……………………………………………………………………………….

1. Medical Conditions:

Medical conditions:……………………………………………………………………………….

……………………………………………………………………………….

……………………………………………………………………………….

Allergies:……………………………………………………………………………….

Please note that meals offered at Wild Rescue will be vegetarian.

1. Travel and Medical Insurance/ Vaccinations :

Volunteers cannot be accepted without good medical insurance that includes cover for emergency hospital treatment for medical and accidental risks and medical evacuation and repatriation costs.

You may choose your own insurer but we do require you to notify your insurer that you will be volunteering at a wildlife sanctuary and staying in a wildlife area. (Please make a note on your policy of the date that you confirmed this with the insurer, and the contact person you spoke to.)

South Africans with medical aid must also inform their medical aid company about volunteering with wildlife and staying in a wildlife area, and supply details of the policy to Wild Rescue.

We further require that your travel and medical insurance policy meets the following minimum requirement:

Hospitals in South Africa will require authorisation and a Guarantee of Payment letter from your insurer before medical assistance can be given – except in situations where “life or limb” are at risk. If you are admitted to a hospital, the hospital staff will assist you with this.

International SOS ( and Europ Assist ( insurers are held in high regard by our local hospital for their prompt response and reliability. Policies by these companies are therefore recommended provided they have acknowledged that you will be working with wildlife.

Please note that minor medical expenses, such as a doctor’s visit or medications, will usually have to be paid up front by yourself (you should be able to claim back from your insurer). Please therefore ensure that you have sufficient funds available. A credit card is recommended for this purpose, butplease make sure that you have pre-authorised out -of-the-country transactionswith your card provider.

We require a copy of your medical insurance documentat least 3 weeks prior to arrival.

Do you have travel andmedical insurance: …………………………………………………………………

Name of Insurance Company/ Plan: …………………………………………………………………………

Contact Details: ………………………………………………………………………….

Have you confirmed cover for working in a wildlife sanctuary and on a nature reserve? ……

If Yes,please would you supply a copy of the insurance policy, and the name and date of the person with whom you confirmed the cover for a wildlife sanctuary and nature reserve.

If No,please would you do this as soon as possible once your booking at Wild Rescue is confirmed, and let us have a copy (as above) no later than 3 weeks prior to arrival.

Please Note: You are required to be vaccinated for Hepatitis A&B, Tetanus and to have had a TB test (the skin test is acceptable). This is to enable you to work with the animals’ food and go into the enclosures for cleaning or enrichment, and to work with the orphans. Please e-mail your certificates and bring them with you. Please see general information for more details on other vaccinations.

1. Education and Specialised skills:

High/ Senior School Qualification (if applicable): …………………………………………………..

Tertiary Education Qualifications(if applicable): …………………………………………………..

……………………………………………………………………………….

Other specialized qualification or skills which may be used for a project for the sanctuary (if applicable):

……………………………………………………………………………….

……………………………………………………………………………….

Current Studies (if applicable): Degree/Diploma : …………………………………………………

Key Subjects: ……………………………………………………………………………….

1. Current Job(if applicable): Title : ……………………………………………………………………

Duties: ……………………………………………………………………………….

……………………………………………………………………………….

1. Previous Volunteering Experience (if applicable):

Organisation:……………………………………………………………………………….

Dates & Duties:……………………………………………………………………………….

……………………………………………………………………………….

1. Motivation for volunteering atWild Rescue:

………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………

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1. Expectations ofWild Recue Volunteer Programme?

………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………

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1. Method of Transport to Riversdale and Estimated Time of Arrival: (if already confirmed)

Flight to Cape Town International Airport

Baz BusCape Town - Riversdale

Other Bus Cape Town – Riversdale

Own transport to Wild Rescue

Other: ………………………………………………………………………

Date: …………………………………………….. ETA: ......

1. Payment of Deposit:

Wild Rescue require a 50% deposit to confirm your booking, and the full payment of the remaining 50% must be made prior to your arrival. The transaction costs must be carried by the applicant.

Please state your surnameon the bank transaction reference plus Volunteer.

Wild Rescue SA Banking Details

Bank: / Standard Bank
Account Name / The Wildlife Rescue Sanctuary NPC
Account Number / 270378871
Branch Name / Fish Hoek (South Africa)
Branch code / 036009

Deposit paid: Yes/ No.

1. Acceptance

This application is subject to acceptance byWild Recue, who reserves the right to refuse any applicant without stating any reason.

Any deposits paid will be refunded in the above instance.

1. Refund of Deposit

The 50% deposit is not refundable unless for reasons of health in which case a doctor’s certificate is required, or due tomitigating person circumstances acceptable to Wild Rescue.

If a volunteer booking is cancelled for whatever reason by Wild Rescue,the full deposit will be refunded.

1. Agreement to Terms and Conditions

In completing this application form and paying the deposit, you agree to abide by all Rules and Regulations governing The Wildlife Rescue Sanctuary NPC T/A Wild Rescue, implicit or explicit.

You acknowledge the requirement of good medical cover as specified under point 6. and agree to supply us with a copy of your insurance prior to your arrival.

You agree to sign the requisite indemnity forms prior to, or on arrival at Wild Rescue.

Date : ……………………………………………………..

Signed: ……………………………………………………..

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