Puppy Training Class Form

Address
Address*
I understand that my puppy must be up to date on vaccinations and that I will be required to send proof of current vaccinations to ebourne@memphishumane.org prior to attending class.*
I understand that all puppies must have received at least one DAPP/DHPP vaccine by a veterinary professional at least 7 days prior to their first class and that puppies aged 16 weeks and older must have a current rabies vaccination. It is strongly recommended that puppies receive a Bordetella vaccine and be current on age-appropriate deworming protocols as advised by a veterinarian.*
I understand that I am responsible for providing up-to-date vaccination records prior to the start of class and maintaining vaccination status throughout the duration of the class. Puppies showing signs of illness or lacking required documentation may be denied participation to ensure a safe training environment for all dogs.*
Has your puppy bitten a person?*
Has your puppy bitten another dog?*
The Undersigned acknowledges that he/she desired to engage in certain services (collectively, the “Services”) with the Humane Society of Memphis and Shelby County, a Tennessee nonprofit corporation (the “HSMSC”). The Undersigned further understands and acknowledges that certain risks may be associated with engaging in the Services. In consideration of being permitted to engage in the Services with HSMSC, the Undersigned, for him/herself and his/her heirs and representatives, voluntarily and knowingly executes this document and expressly waives any and all rights, claims, or causes of action including, without limitation, those involving bodily injury, property damage or death to the Undersigned, or to the Undersigned’s family or property while the Undersigned is engaged, directly or indirectly, in the Services, whether or not caused by the negligence of HSMSC, its officers, directors, agents or employees. In further consideration of being permitted to engage in Services with HSMSC, the Undersigned hereby agrees to indemnify, defend and hold HSMSC, its officers, directors, agents and employees harmless from and against any and all liability, damage, loss, cost and expense incurred as a result of any claim, demand or cause of action brought against HSMSC, its officers, directors, agents or employees, jointly or individually, for bodily injury or property damage suffered as a result of the Undersigned’s negligent, reckless or willful act or omission in the engagement (or failure to engage) of the services. The Undersigned has read and fully understands the contents of this Waiver of Liability and Agreement to Indemnify. This Waiver of Liability and Agreement to Indemnify shall continue in full force and effect until terminated in writing and in the event of such termination shall remain applicable to all matters occurring or first arising on or before the date of such termination regardless of such termination. Also, the Undersigned hereby grants permission to HSMSC to use my image (photographs and/or video) for use in media publications including videos, email blasts, recruiting brochures, newsletters, magazines, general publications, websites, social media, and other forms of media publications. The Undersigned hereby waives any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and waive any right to royalties or other compensation arising from or related to the use of the image. The Undersigned is free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that the failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. The Undersigned has read this Waiver of Liability and Agreement to Indemnify and the Media Release Form before signing or checking below, and fully understands the contents, meaning, and impact of this waiver and release.*

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Puppy Training Class*

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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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935 Farm Road, Memphis, TN 38134 (901) 937-3900

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