My human's name is
* My human's name is
My name is
I am a
How old are you?
Do you have any health concerns/ allergies/or food restrictions we should be aware of?
In the past have you had any issues controlling your impulses to destroy/checw: furniture, building materials, clothing, etc.?
In the past have you found yourself takin gyour anger out on there dogs and/or humans?
Would you consider yourself a bit of a conversationalist? In other words,. do you communicate excessively in bark?
In the event that there was an incident, would the human take full responsibility for any sickness, aggression, disruptive behavior and handle in a discreet and respectful manner?
If an event like this occurred more than THREE times, can you and the human assume the responsibility that this environment is not the best fit and will take action to work remotely or from another workspace?
Battery 621 will agree to notify you and the human of any reported or witnessed occurrences of said “incidents” via email. An acknowledgment of the incident must be made via email to firstname.lastname@example.org, should the incidents exceed three, you _______________(insert dog name here) and __________________(insert human name here) agree, ___________________(dog) will no longer be welcome within the walls of Battery 621.
The owner of the dog agrees to maintain copies of all pertinent pet medical information on premises and agrees to the following minimum requirements.
• All vaccinations, including bordetellosis, are complete and current.
• Parasite control is being done on a routine basis and the animal is free of ticks and fleas.
• The dog has no recent history (6 months) of infection or ringworm.
The owner of the dog agrees to observe the following guidelines. Authorization is granted at the sole discretion of Battery 621 and can be revoked at any time.
• Owner will be solely responsible for all clean-up inside and outside the building. This includes keeping a dog off all Battery related furniture.
• Owner will immediately clean up any accidents or messes using appropriate clean-up and disinfectant measures.
• Owner will not bring to work a dog that has not been fully house trained.
• Owner will not bring a dog to work that is ill or behaving abnormally and will remove the dog from the premises if it becomes ill while on physical property.
• Owner will not bring a dog to work that has bitten or is aggressive, destructive, or excessively vocal.
• Owner must control the dog at all times using a leash while walking the dog and some form of appropriate containment in their work area.
• Owner has sole responsibility for care of the dog while on physical property.
• Owner will utilize designated supply of compostable bags at all times and is responsible for the appropriate disposal of dog waste.
WAIVER OF LIABILITY:
In consideration of being permitted to bring ones dog to Battery 621, the dog owner hereby unconditionally releases, indemnifies, waives, discharges and agrees to hold harmless Battery 621 ownership, staff, tenants or guests from any loss, damage, liability and expense, including court costs and attorney fees, that may be incurred as a result of injuries, including death to persons or dogs, or damage to property, directly or indirectly associated with the owner bringing his/her dog to Battery 621, whether caused by the negligence of ownership, staff, tenants, guests or otherwise.
BY SIGNING THIS AUTHORIZATION AND RELEASE, THE DOG OWNER EXPRESSLY ACKNOWLEDGES AND REPRESENTS that he/she has carefully read the foregoing terms and conditions, understands the contents thereof and signs voluntarily; he/she is at least eighteen (18) years of age and fully competent; and executes this Authorization and Release intending that he/she, his/her spouse and family members, and his/her heirs, assigns and personal representatives if deceased, be legally bound by same.
I have discussed the foregoing Authorization and Release with the dog owner and am agreeable to the tenant bringing his or her dog to the Battery 621. I approve this request, subject to the tenant following these and other Battery 621 guidelines in demonstrating responsible dog ownership.
AUTHORIZED REPRESENTATIVE OF BATTERY 621 DATE
I acknowledge and agree to the conditions provided above.