Request edit access
Waiver of Liability and Assumption of Risk Agreement for Use of Premises
Please complete if you plan on using the property at Green Mountain Dog Camp, LLC.
Sign in to Google to save your progress. Learn more
Waiver:  In consideration of my use of the premises at Green Mountain Dog Camp, LLC, I for myself, my heirs, personal representative or assigns, do hereby release, waive, discharge, and covenant not to sue Green Mountain Dog Camp, it’s owners, trustees, directors, officers, employees and agents from liability from any and all claims including negligence resulting in personal injury, accidents, or illnesses (including death) and property loss arising from use of premises. *
Assumption of Risk:  Hiking on premises with on- or off-leashed dogs carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries.  Such risks (to dogs and humans) include but are not limited to the following:  sprained joints, broken bones, lacerations, puncture wounds, getting lost or disoriented, wild animal confrontations including porcupine strikes, previously laid animal traps and hot and cold exposure.  I know, understand and appreciate these and other risks that are inherent in the activity in which I am participating.  I hereby assert that my participation is voluntary and that I knowingly assume all such risks. *
Indemnification and Hold Harmless:  I also agree to indemnify and hold harmless Green Mountain Dog Camp, LLC, its owners, trustees, directors, officers, employees and agents from any and all claims, actions, suits, costs, expenses, damages and liabilities including attorney fees as a result of this use of premises. *
Severability:  I further expressly agree that the forgoing waiver and assumption of risk agreement is intended to be as broad and inclusive as is permitted by the law of the State of Vermont and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. *
Acknowledgement of Understanding:  I have read this waiver of liability, assumption of risk, and indemnity agreement, and fully understand its terms.  I acknowledge that I am signing the agreement freely and voluntarily, and intend be a complete and unconditional release of all liability to the greatest extent allowed by law. *
I appreciate that you may want to, on occasion, invite guests to hike along with you and your dog(s).  I agree to disclose the names of the guests to the owner of Green Mountain Dog Camp, LLC, prior to each arrival and have each guest fill out this Waiver of Liability. *
Please provide the following information:  Your name, your dogs name, your email address and your telephone number. *
Thank you so much.   I hope you enjoy your time here at Green Mountain Dog Camp!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms