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Canine Connection Liability & Release

Contact
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Email:
Phone:
I agree to the terms of photo release:
I grant to the Humane Society of the Treasure Coast and The PR Czar® Inc., its representatives and employees, the right to take photographs of me and my property in connection with the above-identified subject. I authorize the Humane Society of the Treasure Coast and The PR Czar® Inc., its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that the Humane Society of the Treasure Coast and The PR Czar® Inc. may use such photographs of me with or without my name and for any lawful purpose, including for example, such purposes as publicity, illustration, advertising, and web content.
I have read and understand the privacy policy below:
PRIVACY STATEMENT - THE HUMANE SOCIETY OF THE TREASURE COAST, INC. VALUES ALL OF OUR DONORS, SUPPORTERS, AND VISITORS TO OUR WEBSITE. WE HONORTHEIRPRIVACY,SOWE DO NOT SELL, TRADE, OR SHARE THE PERSONAL INFORMATION WE HAVE GATHERED. SIMILARLY, WE DO NOT SEND DONOR MAILINGS ON BEHALF OF OTHERORGANIZATIONS.TAXID:59-0774235.
I agree to the terms of the hold harmless release:
I, being of lawful age and the owner of the aforementioned dog, hereby understand the educational purposes of the Humane Society of the Treasure Coast, Inc. (“HSTC”) Puppy, Obedience, and Agility Classes, testing for Pet Therapy registration by an accredited tester/observer, and in consideration of being allowed to participate in the training classes being provided by HSTC, hereby acknowledge and agree (on behalf of my family members, heirs, legal representatives, and agents) that: Training can cause stress in dogs and that such training will be done in the presence of other persons and animals. There are risks and dangers involved in these training activities. I accept full responsibility of any and all risk of injury or other consequence to my dog and myself that may be incurred while we participate in these activities. I hereby release and hold harmless the HSTC, its officers, agents, directors, employees, representatives, volunteers, other enrollees, and the instructor/trainers from any and all claims, demands, expenses, and liability, including but not limited to any personal injury, emotional trauma, death, or property damage, incurred by the undersigned that may arise from my participation in any HSTC agility or obedience, training, classes, or other functions. I have carefully read and understand this Release and Hold Harmless Agreement. By completing this form, I affirm my identity, and verify my voluntary intent to Release and Hold Harmless HSTC. I further acknowledge that by checking the box above, it serves as my electronic signature and it is intended to and shall have the same force and effect as my handwritten signature.
I agree to the terms of the COVID-19 waiver:
I attest that to the best of my knowledge, I do not have COVID-19 at the time of attending any Humane Society of the Treasure Coast (“HSTC”) event, class, or training and understand the risks of unknowing exposure to this and other illnesses by myself, my family, other participants, and third parties. I have not been tested and found positive, am not waiting for test results, and do not have symptoms. I agree that I will not knowingly expose others to any illness I may have or be at risk of. I will follow all HSTC rules and requirements to reduce any exposure and possibility of contracting or spreading the virus. I agree that I am attending a class or an event at HSTC entirely at my own risk and assume all risk and full responsibility for my health, wellbeing, and safety during this class or event. I fully agree that HSTC, the officers, board members, and volunteers are in no way liable for any present or future COVID-19 exposure incurred at any time by any person in attendance or not in attendance, during, or after this event. I hereby waive and release HSTC, the officers, the board members, volunteers, and Landlord from any liability for damages or personal injury to me, my pets, or my property.
First and Last Name. Your typed name will serve as your official signature on this liability and release contract.
Typed Signature:
 

 

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Contact Us

Humane Society of the Treasure Coast
4100 SW Leighton Farm Ave
Palm City, Florida 34990
Main Line: (772) 223-8822
Fax: (772) 220-3610
admin@hstc1.org

Journalism inquiries only:       Contact Doreen Poreba at prczar@prczar.com

Registered 501(c)3 Non-Profit
Tax ID #:  59-0774235

 

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Thrift Stores

Central Thrift Store:
3302 SE Federal Hwy., Stuart, FL 34997
(772) 286-6909

North Thrift Store:
1099 NW 21st St., Stuart, FL 34994
(772) 232-4887

Contributions:
A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling toll free (800) 435-7352 within the state or by visiting FDACS.gov. Registration does not imply endorsement, approval or recommendation by the state. Registration #CH1552.

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© 2025 Humane Society of the Treasure Coast, Inc. All Rights Reserved.

Tax ID #: 59-0774235