DOG PARKMEMBERSHIP APPLICATION
Owner(s) Name: ______
Address: ______
City: ______State:______Zip: ______
Home Phone: ______Work Phone: ______
E-Mail Address: ______
Veterinary Clinic: ______
Dog #l:
Dog's Name: ______Breed: ______Sex:____Age :____(Yrs)
Current Rabies Tag #______Expiration Date______
Has this dog been spayed or neutered? Yes No
Has this dog ever show aggressive tendencies toward people?Yes No
Has this dog ever show aggressive tendencies toward other dogs?Yes No
Has this dog ever bitten a person or another dog?Yes No
Has this dog had any kind of attack training? YesNo
Dog #2:
Dog's Name: ______Breed: ______Sex:____Age:____(Yrs)
Current Rabies Tag # ______Expiration date:______
Has this dog been spayed or neutered? Yes No
Has this dog ever show aggressive tendencies toward people?Yes No
Has this dog ever show aggressive tendencies toward other dogs?Yes No
Has this dog ever bitten a person or another dog?Yes No
Has this dog had any kind of attack training? YesNo
By signature below, I expressly agree that my membership is contingent upon following all the Dog Park Rules and Regulations as modified from time to time. I acknowledge that a copy of the present Rules and Regulations has been given to me and that these Rules and Regulations may in the future be revised or amended. I have read, understand, and agree to all provisions of the “Contract Regulations” and “Assumption of Risk, Release and Waiver of Liability, and Indemnity Agreement’ provisions set forth on the reverse side hereof.
Owner Name Printed______Signature ______Date______
Co-Owner Name Printed______Signature ______Date______
DOG PARK STAFF TO COMPLETE:
Date Data Entered: By:
DOG PARK MEMBERSHIP APPLICATION
Contract Regulations
By signing this contract you, the Buyer(s), have purchased for your dog(s) a membership to the Dog Park. Buyer(s) agree that the membership fee is non-refundable unless the Dog Park is no longer able to provide a substantial number of the services offered when this contract was signed, in which case Buyer(s) will receive a prorated refund.
Buyer(s) agree that the membership is not transferable to another dog owner. Other dogs owned by the Buyer(s) may be substituted for those named on the application provided they, evidence a current rabies tag, meet other park requirements and are approved by the park management.
Additional dogs owned by the Buyer(s) may be added to those named above provided they, evidence a current rabies tag, meet other park requirements and are approved by the park management, and the difference in membership rate is paid.
Buyer(s) may cancel this contract without penalty and receive membership refund (minus initiation fee) within 7 calendar days of the date membership begins. The Dog Park reserves the right to deny entry to the facility or membership in the facility for any reason, and to terminate membership or expel a person and/or dog from the facility for any reason. If the Dog Park terminates a membership, the corporation reserves the right to return pro-rated fees or no fees.
Assumption of Risk, Release and Waiver of Liability and Indemnity Agreement
The Dog Park has created a park for dogs and their owners and guests to enjoy together. I understand that the use of the Dog Park facilities means that I am taking certain risks of injury to myself, my minor children (under 18), my guests, my dog(s) and my property. I realize that when dogs are around strange people and other dogs, accidents or injuries may result, and that dogs, people, and property might be injured or damaged.
Because I want to use and enjoy the Dog Park and its facilities, I hereby agree to assume these risks for myself, my guests, my minor children, my dogs, and my property. I agree that it is solely my responsibility to determine whether the Dog Park property itself and any particular situation involving other members, guests and dogs is safe for myself, my minor children (under 18), my guests, my dogs, and my property. I expressly assume the risk of personal injury or property damage arising out of or related to my use of the Dog Park.
In exchange for the opportunity to use the Dog Park, I hereby release, discharge, and hold harmless the City of Fernandina Beach and its representatives, officers, employees, and agents,Fernandina Beach Animal Rescue Inc.(including but not limited to its operations involving the Dog Park) and Nassau Humane Society Inc. their respective, officers, directors, volunteers, shareholders, property landlords, appointees or representatives, employees and contractors from any and all liability, claims, demands, causes of action, or any other legal cause arising out of or related to loss or damage or injury to person or property, including any death or serious injury which may result while I, my minor children (under 18), guests, or my dogs are at the Dog Park. I also agree to be responsible for my, minor children, guests and my dogs and for any liability caused by me, my minor children, guests and my dogs.
I also release any other member of the Dog Park from any claims, causes of action, or other legal cause arising out of or related to the activities of such member’s dog(s), including any injury such dog(s) may cause to me, my guest, my minor children, my dog(s) and my property, except where such claim, causes of action, or any other legal cause arises out of the gross negligence or willful misconduct of such member.
I further agree to hold harmless and indemnify the City of Fernandina Beach and its representatives, officers, employees, contractors, and agents, and Fernandina Beach Animal Rescue Inc. (including but not limited to its activities involving the Dog Park) and the Nassau Humane Society Inc. and their respective officers, directors, volunteers, shareholders, property landlord, or appointees or its employees, contractors and agents for any claims, causes of action, lawsuits or judgments against any of the foregoing entities or persons that are asserted because of any action or inaction of myself, my minor children (under 18), my guests, or my dogs. This indemnification shall include court costs and attorney fees and costs, including costs of appeal.
I have read, understand, and agree to abide by all of the Contract Regulations, the Dog Park Rules, and the Indemnity Agreement, Release and Waiver of Liability and Assumption of Risk. I understand that the Dog Park management reserves the right to alter or amend its rules at any time. I intend for this release to be binding upon my heirs, beneficiaries, next of kin, personal representative or executor and assignees.
Owner Name Printed______Signature ______Date______
Co-Owner Name Printed______Signature ______Date______
DOG PARKRULES AND REGULATIONS
(Please initial each rule.)
_____ Watch your dog and keep him or her within your command at all times, keeping your dog's leashwith you.
_____ Dogs must be on leash entering/leaving the park. When in the off-leash areas, they must be off leash,except in the case when you must correct or evacuate the dog. Leashes must be with youAT ALL TIMES.
_____ No bullies! Rough play is fine as long as it is consensual. Rough play and chasing are notacceptable if any of the dogs involved or owners are not comfortable with the situation.
_____ Dogs must be current on all vaccinations for entry.
_____Dog Feces: Owners are responsible for cleaning up after their dogs.
_____Do not let anyone other than your guests and paid-for dog guests through the member gate at anytime, regardless of what they tell you. Direct them to our office. Make sure you close themember gate after you, even if people are waiting to go through the gate.
_____ Non-Member Dogs: Members may bring non-member dogs with them only during the hours thePark office is open, and upon paying the visitor's fee. Non-Member Dogs must exhibit a current Rabies tag and as a basic condition of entry. A visitor dog may not be brought into theoff-leash park during any other times unless prior arrangements with management have beenmade. Members may bring people guests with them at any time.
_____Digging: Do not let your dog dig holes.
_____Barking: If your dog is barking excessively, you will be asked to leave the park.
_____ Children: Children under age 13 are not allowed in the park. Children under 18 must be withindirect adult supervision everywhere while on park property and are never to be further than 10feet from an adult. Children must follow all rules and not be allowed to destroy any property,including pulling on, standing on, leaning on any fence, park equipment, dog training equipmentor any other assets of the Dog Park.
_____All dogs must be spayed/neutered to enter the park.
_____ Food: Nothing edible for dogs or people in allowed in the off-leash areas of the park. Humandrinks are permitted.
_____ If aggressive behavior is observed, take immediate action: move your dog to another area orleave the park. Please report incidents to management.
_____ Dog fights: To avoid a dog fight, I agree that I can control and command my dog while in thepark and I will keep watch over my dog while in the park to insure it is not exhibiting aggressiveor antagonistic behavior. I further agree that I will do everything possible to remove my dogfrom situations uncomfortable to me, my dog, or other dogs or their owners. I further understandthat under no circumstances should I ever grab a fighting dog by its collar or anywhere nearthe biting end of the dog, as I risk being bitten or otherwise attacked.
_____ Dogs that are sick and dogs with obvious external parasites or conditions (e.g. Fleas, mange) are not permitted in the Park. Due to the outside nature of the Park, we strongly recommend flea and tick treatments at all times.
_____ Any and all dog training equipment can be used only under supervision of the trainer, except inthe off-leash area. People, including children, can never sit, stand, jump over, or play on any dogtraining equipment.
_____ No more than 3 of your registered dogs in your household are allowed in the Park per visit.
_____ Membership dues are payable monthly, semiannually, or annually.
_____Report lost or stolen access keys to management immediately. You are responsible for anyunauthorized person accessing the park using your key.
_____Please respect the privacy of our neighbors.