The following Release, Waiver and Indemnification Agreement must be submitted for each attendant at Pug Camp 2019. The Release Waiver and Indemnification must be signed by each individual in attendance. If you registered for multiple people, please make sure they fill out this form as well.
Retain a copy for your records. Minors, i.e., anyone under the age of eighteen (18) must have a parent and/or guardian sign on their behalf.
ACKNOWLEDGEMENT OF RISK, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT
I understand that participation in the Pug Camp 2019 at Camp Westmont is not without risk, and the possibility of harm or damage to myself, my dog, or my property. Although health and safety precautions will be taken, factors such as the personality of a dog, the level of dog handling experience of others, the various types of physical activity, and the unpredictable nature of animals pose certain levels of risk beyond the control of Pug Squad Inc. Neither Pug Squad Inc. nor Camp Westmont assumes any responsibility for any aspect of the safety of human participants, dogs or property. My participation in camp is done voluntarily and in full recognition of the risks to me and my dog, which risks I agree to fully assume while in attendance at Camp Westmont.
Therefore, in consideration of my participation in Pug Camp 2019 at Camp Westmont, and for other valuable consideration, the receipt of which is hereby acknowledged, I, the undersigned, individually and/or as parent or guardian of my minor child/children, if applicable, hereby and forever release, discharge and hold harmless and indemnify Pug Squad Inc. and Camp Westmont, its employees, officers, directors, agents, contractors, and volunteers from any and all actions, cause of action and claims for personal injury or property damage, regardless of cause, including negligence on account of or in any way growing out of directly or indirectly, actions of myself, my dog or others participating in, conducting, or in attendance at Pug Camp 2019.
I hereby certify that the foregoing statements made by me are true and correct and that Pug Squad Inc. and Camp Westmont have relied upon the truthfulness of information I provided in order to allow me and my dog/dogs, and minor child/children to participate in Pug Camp 2019.
- I am the parent/guardian of a child under 18 years of age (if applicable).
- I have been fully informed of all the rules and policies of Pug Camp 2019, and I agree to abide by all such rules at all times.
- I understand the control of my dog is always my sole responsibility.
- I have no medical or physical conditions which would prevent me or my dog in participation of any activities. I certify that my dog is healthy and free from contagious disease.
- I have kept a copy of the RELEASE.
- I understand that any time my dog or I behave inappropriately, Pug Squad Inc. and Camp Westmont have the right to dismiss my dog and me from the premises, without refund.
- I agree to be responsible for any damage caused by me or my dog to Camp Westmont property, lodging facilities, or property of others while at camp.
- I understand that the use of the lake and/or pool is at my own risk and that of my dog.
- I will permit Pug Squad Inc. the free use of my name and pictures in any Pug Squad materials which includes Pug Camp.
THIS RELEASE IS GOVERNED BY THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA.
I CERTIFY THAT I HAVE READ AND VOLUNTARILY EXECUTED THIS WAIVER AND RELEASE OF ALL LIABILITY AND INDEMNIFICATION AGREEMENT.