Corporate Headquarters
P.O. Box 266
1833 Park Lane
Burlington, WA 98233
Office: (360) 757-6053 / Fax: (360) 757-4143

Dog Waiver

Country Store Waiver and Release of Liability

Assumption of Risk and Indemnity Agreement
Name(Required)
MM slash DD slash YYYY
I agree that in consideration for my Pet being permitted to be a client at Skagit Farmers Supply (dba Country Store) (the “Company”), I make the following representations and agree to all the following policies, procedures, terms and conditions:

1. I agree and represent my Pet is in good health, has not injured or shown threatening behavior to any persons or animals, is current on all vaccinations required and is free of parasites.

2. I understand that if there are children in my party, I am responsible for supervising them. Ensuring they are not petting other’s pets without permission, nor are they running or climbing on personal property. Any damages to personal property will be at the cost of Responsible Party.

3. I agree and accept responsibility and liability for acts or damages caused in relation to behavior or incident of my Pet including but not limited to, injury or death to any other animal, persons, and/or medical treatment expenses incurred by such incident.

4. I understand that I am responsible for supervising my pet at all times and will not leave my pet unattended. I agree to keep my pet on a leash and under my control at all times, both inside the Company’s facility as well as in and around the parking lot.

5. I expressly acknowledge that due to the services made available it is likely that there will be wet floors, risk of slipping or incurring injury to both animals and people is possible, and I still agree to the terms herein.

6. I agree that the Company shall not be responsible or liable for any lost, stolen, or damaged personal property.

7. The Company has the right to refuse services. In the event the Pet becomes stressed or dangerous, the Company may elect to stop, cancel or refuse services at any time, before during or after use of the facility.

8. I grant the Company the right to use my Pet and its name in any form of advertising and marketing of which no compensation will be paid to me.

9. I acknowledge that the Company provides grooming tools and products which meet industry standards for pet washes. I accept responsibility for any allergic reaction and or injury caused by my use of such tools and/or products on my pet.

The undersigned shall defend, indemnify, and hold harmless the Company and its employees, representatives, agents, attorneys, contractors, successors and assigns from and against claims, damages, losses, and expenses, including but not limited to attorneys’ and experts’ fees, arising out of or resulting from: (1) any and all damage caused by the undersigned’s pet, including but not limited to damage to a third party and or a third party’s pet; (2) the services provided by the Company. In no event shall the Company be liable for more than the cost of services provided and paid for by the undersigned party.

THIS AGREEMENT CONTAINS A WAIVER, RELEASE, AND INDEMNITY AGREEMENT
Clear Signature
1833 Park Lane · P.O. Box 266 · Burlington, WA 98233 Phone (360) 757-6053 · Fax (360) 757-4143 · www.countrystore.net