Herd Dog Release of Liability – NZ Ewe-Topia Ranch

Name *

First

Last

Phone Number *

Address

Emergency Contact *

First

Last

Emergency Contact Phone Number *

What is your Dogs Name and Breed? *

My dogs are up to date on all vaccines and shots or treatments and can produce a copy if asked *

Yes
No…Talk to Instructor if you check this box

Please Read ALL of the Following and check each box next to the statement. At the end you Will be asked to Sign your name by typing your full name and then hit the SUBMIT button. An electronic copy will be sent to [email protected] and will be kept as part of our records. *

Understood

HERD DOG TRAINING LEGAL RELEASE OF LIABILITY FORM: By checking the box you are acknowledging you understand and agree to the terms of the release form. Failure to do so will result in the refusal of your dog(s) into our training program. If you have questions, comments or concerns about any of the statements below please consult with a staff member. *

Understood

I acknowledge that I am voluntarily choosing to have my dog(s) participating in herding, training, obedience, socializing and any other approved activities while at NZ Ewe-Topia Ranch. *

Understood

Photography and Video: I understand that I may not take any photographs, videos or audio recordings of any kind on NZ Ewe-Topia property without prior authorization from a staff member. *

Understood

Inherent Risk : I understand that every precaution will be taken to ensure the safety of my dog(s), as well as myself and member of my party. *

Understood

I acknowledge that incidents may arise because of the inherent risks involved in training a dog, working with livestock, and/or persons or any other dog-related activities. *

Understood

I understand that by having my dog(s) participate in these activities while at NZ Ewe-Topia Ranch that there may be risk involved and I agree to assume that risk. *

Understood

I understand that by having my dog(s) participate in these activities while at NZ Ewe-Topia Ranch that there may be risk involved and I agree to assume that risk. *

Understood

I acknowledge that risks of harm may include, but are not limited to; injury to dog(s) or to persons due to biting or fighting with other dog(s) or persons; injury from interactions with livestock; injury from personal items on the grounds of NZ Ewe-Topia Ranch; injury from methods of correction, and such and similar harms including the possibility of serious illness or death. I acknowledge and agree that NZ Ewe-Topia Ranch, its officers or owners, agents, employees, and Gabriel R. Kelly and Patricia R. Kelly individually, are not responsible for any damage/injury caused to my dog(s), person or property while on the premises of NZ Ewe-Topia Ranch. *

Understood

I agree to knowingly waive any and all claims against NZ Ewe-Topia Ranch, its officers or owner, agents, employees, and Gabriel R. Kelly and Patricia R. Kelly individually arising out of the services and activities which occur at NZ Ewe-Topia Ranch. I knowingly agree to release from NZ Ewe-Topia Ranch, its officers or owners, agent, employees, and Gabriel R. Kelly and Patricia R. Kelly individually, from any liability arising out of any services provided. *

Understood

I acknowledge I will abide by the rules, terms and conditions imposed by NZ Ewe-Topia Ranch through a document provided to me, posted rules and/or through oral instructions given by Gabriel R. Kelly or Patricia R. Kelly or any other staff member. I acknowledge that all persons in my party or on my behalf who may enter NZ Ewe-Topia Ranch property are subject to the terms and conditions of this agreement. *

Understood

I acknowledge and agree anything that is not specifically outlined in this agreement does not permit myself, members of my party or persons on my behalf to take legal action against NZ Ewe-Topia Ranch, its officers or owners, agents, employees, and Gabriel R. Kelly and Patricia R. Kelly individually

Understood

I fully acknowledge that I have read and understand the terms of this agreement, release of liability and waivers. I understand that I am required to enter in to these agreements in order to participate in the activities at NZ Ewe-Topia Ranch and that a failure to consent to the conditions requires me to leave the premises immediately. By signing below, I agree to abide by and be bound by the terms and conditions of this contract, and to comply with all rules and policies in *

First

Last