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Lexington Humane Society
1600 Old Frankfort Pike, Lexington, KY 40504
(859) 233-0044
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Check Me Out Program: Blind Date Agreement Form
Check Me Out Agreement
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MM slash DD slash YYYY
Please list any animals in the home:
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Please let us know what's on your mind. Have a question for us? Ask away.
Consent
(Required)
I understand all Lexington Humane Society (LHS) rules and Fayette County animal ordinances must be followed at all times, which include but are not limited to leash laws, animal waste disposal laws, and barking dog/noise laws.
I agree to follow the Dos and Don’ts list during the entire time the dog is in my care.
I agree to have the dog back no later than 5:00pm on the same day I checked the dog out.
I understand that failing to bring the dog back by 5:00pm will result in a report filed with the police.
I will follow any extreme temperature protocols that LHS has in effect today.
I agree to release, discharge, indemnify and hold harmless LHS, a non-profit Kentucky corporation with its principal place of business being located in Lexington, Kentucky, its officers, directors, and employees for any and all claims, demands, losses, costs, liabilities, settlement agreements, damages, expenses and suits at law or in equity that arise out of my performing services for LHS, its officers, directors, or employees.
I recognize that in handling animals while performing services for LHS, there exists a risk of injury including, but not limited to, personal physical harm. On behalf of myself, my heirs, assignees, guardians, and personal and legal representatives and executors, I hereby release, discharge, indemnify, and hold harmless LHS, its officers, directors, and employees for any and all claims, demands, losses, costs, liabilities, settlement agreements, damages, expenses connected with my services to the Society whether caused directly or indirectly by any negligence (active or passive) attributable to LHS, its officers, directors, or employees.
I acknowledge that I have been advised and encouraged to consult with my physician regarding: tetanus vaccinations, rabies prophylaxis, and possible allergic reactions.
I assume all responsibility for this animal and its actions and will assume all liability.
Check Me Out: Dog Walking DOs and DON’Ts
Dos
● Keep dog leashed and tethered at all times
● Take to people-oriented parks or on long walks
● Keep the supply backpack with you at all times
● Keep your cell phone on you at all times
● Provide the dog with a lot of positive reinforcement for good behavior
● Provide fresh water whenever possible
● Promote adoption
● Thank those who are interested in donating to LHS and encourage them to visit one of our two adoption locations or visit AdoptLove.net to make a donation
● Show the dog some love
● Keep all car windows up and locked while traveling
● Keep all car doors locked while traveling
● Pick up the dog’s waste
● Bring the dog back if it seems stressed or uncomfortable
● Know the signs of overheating and hyperthermia
● Tell LHS about the experience so we can inform adopters of behavior
Don’ts
● Take dog to a dog park or any other place with a lot of animals
● Take dog home to meet your animals
● Take dog to overly crowded places
● Take dog outside of Fayette County
● Feed the dog anything other than DOG treats, and do not overfeed treats
● Punish the dog
● Let the dog jump on strangers
● Run with the dog
● Leave the dog in the car
● Let the dog walk on hot pavement for extended periods of time
● Hand the dog off to anyone else
● Let the dog out of your sight
● Take the dog to areas with a lot of children
● Take the dog to a vet
● Drive with the dog in the front seat
I agree to abide by these rules.