EmailMe Form - Waiver of Liability

EmailMeForm

Today's Date *
MM / DD / YYYY
Name *
First Last
Phone *
### - ### - ####
Email *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
What role(s) are you interested in fulfilling? *
Home inspection
Transport
Foster home
Photography
FOSTER Volunteers: Do you have current or prior foster experience? *
No
Yes
FOSTER Volunteers: Is someone generally home during the day? *
No
Yes
FOSTER Volunteers: List other canines present (gender, breed, age, altered)

Canine 1

Canine 2

Canine 3

EX. female Weimaraner 7 spayed
FOSTER Volunteers: Do you have/own any of the following?
Children under 10
Fenced yard
Basic training skills (sit, stay, come etc)
Advanced training skills (resource guarding, barrier aggression etc)
Cat(s)
Birds
Animals not listed here
In consideration for being permitted by Oregon Weimaraner Rescue to participate in a volunteer capacity, I hereby waive, release, and discharge any and all claims and damages for personal injury, death, or property damage which I may sustain or may which hereafter accrue as a result of my participation as a volunteer and resulting from negligence or misconduct of Oregon Weimaraner Rescue. This release is intended to discharge in advance Oregon Weimaraner Rescue, its’ Directors, Officers, and/or agents to include their heirs, agents, representatives, successors and assignees from and against any and all liabilities, actions, claims, demands, costs, or expenses arising from or in any way connected with my participation as a volunteer and resulting from the negligence or misconduct of Oregon Weimaraner Rescue. I understand that various activities involving dogs and/or puppies can be hazardous in nature involving the possibility of being bitten, scratched, jumped on, dragged or knocked over. The possibility of serious accidents and/or injury can occur during participation in volunteer fostering activities. Knowing the risks involved I have voluntarily applied to participate as a volunteer and I hereby agree to assume all risks of injury, and to release and hold harmless Oregon Weimaraner Rescue, its’ Directors, Officers, and/or agents who through negligence or carelessness might otherwise be liable to me. I further agree to indemnify and to hold Oregon Weimaraner Rescue, its’ Directors, Officers, and/or agents free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of any injury and/or property damage I may sustain while participating as a volunteer. I agree that all services I provide are charitable in nature and entirely voluntary, and there will be no compensation of any kind for the performance thereof. Further I have been fully advised that as a non-employee I am not covered by worker’s compensation and am not covered under any medical insurance plan associated with my volunteer position with Oregon Weimaraner Rescue.

Oregon Weimaraner Rescue does not evaluate, guarantee, promise or otherwise warranty the temperament or propensities of any dog or make any claims related to disposition and/or potential for risk to person or property.

BY CLICKING 'ACCEPT' I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER OF LIABILITY, MEDICAL RELEASE , AND INDEMNIFICATION AGREEMENT AND FULLY UNDERSTAND THE CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND LEGAL AGREEMENT BETWEEN MYSELF AND OREGON WEIMARANER RESCUE. *
ACCEPT
DECLINE

Canine 1
Canine 2
Canine 3