Carlisle area dog parks association (CADPA) LIABILITY WAIVER/ASSUMPTION OF RISK
Any questions about this waiver can be emailed to info@carlisleareadogparks.org.
User Information:
Today’s Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name (Primary Contact)
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First Name
Last Name
Secondary Contact Name (if applicable):
First Name
Last Name
Preferred Phone:
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Format: (000) 000-0000.
E-mail:
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example@example.com
Please enter the name of the CADPA member you are associated with (if applicable):
RELEASE OF LIABILITY
RELEASE OF LIABILITY: ACCEPTANCE OF RESPONSIBILITY & RISKS
Please read and initial each section of this agreement, as well as sign and date at the bottom by each owner(s). This agreement must be signed and submitted annually along with membership dues to ensure continued access to the dog park.
(INITIAL) I hereby acknowledge that I have voluntarily applied for permission to use, with my dog(s), the designated dog park area in Shaffer Park, owned by the Borough of Carlisle. My application includes submitted proof of current vaccinations for rabies and Bordatella (kennel cough), documentation of spay/neuter and dog license for each dog. All information provided in this application is accurate and truthful to the best of my knowledge. I understand that falsification or incompletion of required information may result in revocation of dog park privileges.
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(INITIAL) I understand that unleashing my dog and being physically present at a dog park area involves risks of injury to me, any individual(s) accompanying me, other people, my dog(s) and other dogs. Risks include, but are not limited to, exposure to aggressive dogs, unpredictable behavior, and lack of training, as well as dog fights, dog bites, theft or unlawful capture, escape over and under fences, vegetation or standing water that may be unhealthful or poisonous if consumed, burrs or seeds that may become lodged in a dog’s coat, feet, eyes, nose or ears, mosquitoes, ticks, chiggers, fleas, and other insects, and wildlife typically found in a park.
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(INITIAL) I further understand and assume that despite the efforts of CADPA to ensure that owners have complied with requirements for all dogs to have current vaccination for rabies and Bordatella, there is risk that not all dogs present in the dog park are current, and that this could result in harm to other dogs and human beings.
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(INITIAL) I also understand that use of dog park areas is self-directed and not directly supervised by any agent or representative of the CADPA or the Borough of Carlisle. I assume all risks associated with using the dog park, including fixtures and equipment, in a responsible, unsupervised, and self-directed manner.
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(INITIAL) By signing this release, I agree to indemnify and hold harmless CADPA and the Borough of Carlisle, their agents, officers, employees and assigns from and against all loss, cost, damages, expense, and liability resulting from my use of the dog park, including death, sickness, injury, disease to any person or dog, and/or destruction to property (real or personal) arising directly from my use of the dog park.I have read the CADPA Dog Park Rules for use of the Dog Park at Shaffer Park and agree to abide by them. I understand that noncompliance with dog park rules may result in revocation of dog park use privileges.
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(INITIAL) We have carefully read this Release of Liability and understand, agree with, and accept its terms and conditions.
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(INITIAL) I have carefully read and understand the CADPA Park Rules: https://www.carlisleareadogparks.org/park-rules.html
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(INITIAL) I understand that children under the age of 12 are not permitted in the park.
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Print Name of User #1
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Signature of User #1
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Print Name of User #2
Signature of User #2
Signature Date
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Month
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