Flat Request Form

I grant to the Humane Society of the Treasure Coast and The PR Czar® Inc., its representatives and employees, the right to take and use photographs of meand my property in connection with the above-identified subject. I authorize the Humane Society of the Treasure Coast and The PR Czar® Inc., its assignsand 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 PRCzar® 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 agree that I allow HSTC and PR Czar® to use and share any social media or public posts from my account thatrelates to the HSTC adoptable animal program. I agree to promote HSTC and it’s Flat-Animals regularly and in the best interest of the mission. I agreenot to use the Flat or HSTC in any negative publicity against the shelter.

PRIVACY STATEMENT - THE HUMANE SOCIETY OF THE TREASURE COAST, INC. VALUES ALL OF OUR DONORS, SUPPORTERS, AND VISITORS TO OUR WEBSITE. WE HONOR THEIR PRIVACY, SO WE DO NOT SELL, TRADE, OR SHARE THE PERSONAL INFORMATION WE HAVE GATHERED. SIMILARLY, WE DO NOT SEND DONOR MAILINGS ON BEHALF OF OTHER ORGANIZATIONS. TAXID:59-0774235.

I, being the participant of the Flat Out Adoptable program, hereby understand the promotional purposes of the Humane Society of the Treasure Coast, Inc. (“HSTC”). I agree to use the Flat in the best interest of the HSTC and it’s animals. I hereby release and hold harmless the HSTC, its officers, agents, directors, employees, representatives, volunteers, and other enrollees, 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 program, 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 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.