CRCG Liability Agreement

URL

This field is for validation purposes and should be left unchanged.

Please reply with answers to the following questions prior to your first appointment. Sending us this information prior to your appointment will allow more time dedicated to the exam, treatment planning, and answering any of your questions.

Client Information

Client Name*

First Last

Email address

Phone number*

Pet Information

Pet Name*

Liability Agreement:

I have reviewed and selected the above conditions of the liability agreement. CRCG will be unable to treat my pet if the liability agreement is not completed prior to my first appointment.*

Yes

Photo Release

I grant to CRCG, its representatives and employees the right to take photographs of me and my dog in connection with any CRCG services. I authorize CRCG, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that CRCG 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.

Yes

CRCG Recreational Pool Policy

I agree that there are inherent risks to me associated with use of the CRCG facilities arising out of or associated with use and conditions, such as swimming, wet floors, exercise mats, and other dogs. In consideration for CRCG granting me permission to use these facilities, I agree to release CRCG from liability arising out of or associated with such use, and hereafter waive any and all claims which may arise out of or be associated with such permissive use of the CRCG facilities.*

Owner's Name Date

I certify that I have read and understand this Agreement, and that the information set forth above is true and correct. I agree to accept all the terms, conditions, and statements of this agreement, and any rules or regulations of CRCG.