HORIZON LAND MANAGEMENT, LLC Birchwood MHC, LLC Pet Registration / Waiver Pet One Description: Breed: _______________________________ Name: _______________________________ Age: ________ Color: _____________ Indoor: ___________ Outdoor: ___________

Pet Two Description: Breed: ______________________________ Name: ______________________________ Age: _________ Color: ____________ Indoor: __________ Outdoor: __________

Identification: (required) Does this pet have a collar tag? Yes / No If not, when do you plan on getting one? _____________________________________

Identification: (required) Does this pet have a collar tag? Yes / No If not, when do you plan on getting one? ____________________________________

Photo: (required) Included: Yes / No If not, when can you send one? ____________ _____________________________________

Photo: (required) Included: Yes / No If not, when can you send one? __________ ____________________________________

Vaccination: (required) Proof Included: Yes / No If not, please send immediately.

Vaccination: (required) Proof Included: Yes / No If not, please send immediately.

I declare all information to be true & correct. Initials: __________

I declare all information to be true & correct, Initials: _________

Additional Information: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I UNDERSTAND THAT I AM FULLY AND SOLELY RESPONSIBILITY FOR MY PET(S) AND THE ACTIONS OF MY PET(S). I AGREE TO INDEMNIFY THE PARK OWNERS AND MANAGER AGAINST ANY AND ALL DAMAGES THAT ARE CAUSED BY MY PET(S). Signature: ________________________________ Date: ________________