I, being responsible for the above-described animal, have the
authority to grant Dr. Goldman my consent to assess, make
recommendations for, and, in some cases, treat the animal.
Dr. Goldman will use all reasonable precautions against injury
or illness but will not be held liable or responsible in any manner
whatever on account of the animal or otherwise in connection
therewith as it is understood that I assume all risks. I understand
that the behavior of animals is unpredictable and that some animals
are capable of inflicting serious personal injury or death, as well
as significant property damage. I acknowledge that while Dr.
Goldman (and Carleton's Place) will take every reasonable
precaution to minimize the potential of danger posed by the animal,
it is never possible to guarantee the temperament and/or behavior
of any animal at all times and under all circumstances.
I agree to forever release, discharge, indemnify and hold
harmless Dr. Goldman from any and all claims, damages and liability
to me or to any person claiming under, through or on behalf of me,
arising out of or connected in any way with my animal's
All charges shall be made prior to or on the day of the
I warrant that I have the right to enter this agreement. I
represent that I am over 18 years of age.
I HAVE READ THIS AGREEMENT CAREFULLY AND FULLY UNDERSTAND ITS
CONTENTS. I AM AWARE THAT THIS IS A WAIVER, RELEASE OF LIABILITY
AND INDEMNITY AGREEMENT, AND AN ENFORCEABLE CONTRACT BETWEEN DR.
GOLDMAN AND I, AND I SIGN OF MY OWN FREE WILL. This release shall
be binding upon me and my heirs, legal representatives, and