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Pet Parent/Guardian Name*

First Last

Date*

Pet’s Name*

Address*

Street Address Address Line 2 City State ZIP Code

I, the undersigned, do hereby grant permission to Duvall Veterinary Hospital to post my and/or my pet’s story or photo, hereinafter referred to as “Materials,” I submit to and for Duvall Veterinary Hospital’s Web site, Twitter account, Instagram account, YouTube account and Facebook account.

I hereby release you, your representative, employees, managers, members, officers, parent companies, subsidiaries, and directors, from all claims and demands arising out of or in connection with any use of said “Materials”, including, without limitation, all claims for invasion of privacy, infringement of my right of publicity, defamation and any other personal and/or property rights.

I acknowledge and agree that no sums whatsoever will be due to me as a result of the use and/or exploitation of the “Materials” or any rights therein.

I acknowledge that my pet is an animal and lacks the legal capacity to enter into binding agreements. Accordingly, I have read this Release and consent to my pet’s inclusion in the Materials will not contest the rights granted in this Release and shall assist and support you in any and all legal proceeding for affirmation of this Agreement, should you choose to have a court of law affirm this Agreement.

Pet Parent/Guardian Signature*

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