REGISTRATION FORM

This is currently to pre-register your pet for our Summer Opening (Anticipated to be August)

CREATE AN ACCOUNT

To register, create an account, login and complete the registration and consent form.

ENSURE YOUR PET IS UP TO DATE ON THE FOLLOWING:

Rabies

Distemper (DHPP, DHLPP, DA2PP)

Bordetella

Spayed/Neutered (if over 8 months of age)

Up to date Negative Fecal Test

Current on Flea Prevention

UPLOAD MEDICAL RECORDS

Upload a copy of medical records using the link below.

Not up to date? No problem!

Make an appointment with one of our onsite Doctors and get your dog updated to play!

Call 763.337.4433 or Click Here

MAKE A RESERVATION

Click here to reserve a spot in advance. Reservations are not required if your pet has an up to date registration form.

REGISTRATION AND CONSENT FORM

First Name

Phone

Address

Pet Name

Pet Breed

DHPP due date

Date of Negative Fecal

Last Name

My pet is spayed/neutered

Pet DOB

Rabies Due Date

Bordetella due date

Flea prevention due date

Pet's Medical records

Attach here

Waiver and Release of Liability Brew Park Plymouth, LLC d/b/a Brew Park (“Brew Park”), 2605 Fernbrook Lane N Ste J | Plymouth, MN 55447 By signing this document, you will waive certain legal rights, including the right to sue or claim compensation following an accident, significant injury or death to yourself, or your dog(s). Please read carefully. Express Assumption of Risk I recognize there is risk involved in bringing my dog to and entering Brew Park. I understand and acknowledge that dog parks are intended to provide a fun and rewarding experience for myself and my dog(s). I acknowledge that my physical health, and the health of my dog(s) are in a condition compatible with participating at Brew Park. I acknowledge that I should seek medical advice if I know or suspect that my condition or the condition of my dog(s) may be incompatible with Brew Park. I acknowledge that my dog(s) is/are current on their Rabies, Distemper, and Bordetella vaccinations prior to entering Brew Park. I acknowledge that am solely responsible for determining whether or not this is an appropriate activity for my dog(s). I, the undersigned, am aware that there are significant risks involved in using a dog park. These risks include but are not limited to: falls which can result in serious injury, injury or death due to negligence on the part of myself or other people around me, and injury or death due to dog(s). I assume full responsibility for the risks that I am exposing myself and my dog(s) to and accept full responsibility for any injury or death that may result from my and my dog(s) participation at Brew Park. Release & First Aid Authorization In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities available through Brew Park, I release Brew Park, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in activities offered by Brew Park, wherever located, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with Brew Park to administer first aid as is deemed necessary at the time, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child. Use of photographs/videos/image likeness I agree to allow Brew Park and its agents, employees or assigns, the right to use photographs, videos of and/or image likeness of me, and/or the dog for which I own, for use in any publication such as advertising, direct mail, brochures, newsletters, display boards, and to use such photographs in electronic versions of the same publications or on web sites or other electronic form or media. I shall have no right of approval, no claim to additional compensation, and no claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of any such use, alteration, distortion, or illusionary effect or other use in any composite form. I agree that this release does not in any way conflict with any existing commitment on my part.

I have read and accept the above terms & conditions and acknowledge I over 18 years of age.

Signature of Participant

Date of Birth

Today's Date

Thanks for submitting!