Dog Park Application

Membership Pass #: Gate #:

New/Renewal: DATE:

Annual Membership Passes to all of the Greenwood Parks and Recrea�on Dog Parks and Recrea�on Dog Parks are issued for a one-year period and are good for 365 days from the date of purchase. The number of Annual Membership Passes sold each year will be limited to 500 dogs, and memberships will be sold on a first-come, first-serve basis. **All owners/members must be atleast eighteen (18) years of age, and present proof of current vaccina�ons for their dogs as part of the membership applica�on process. Owners/members are responsible for keeping their dogs’ vaccina�ons current and up-yo-date at all �mes. Members may visit the Dog Parks during regular park hours, from dawn to dusk, 365 days a year The Greenwood Parks Department reserves the right to close the Dog Parks at any �me for maintenance purposes. An annual Membership Pass consists of a collar tag for each dog, and a proximity reader for the owner. The collar tag must be visible on the dog while using the off leash zone. The tag for each dog is Fi�y Dollars ($50 00) per dog, per tag Greenwood City Residents will be given a discounted membership fee of Forty-Five Dollars ($45.00) per dog, per tag. Only one proximity reader is allowed per household.

PLEASE COMPLETE ALL LINE BELOW INCOMPLETE OR ILLEGIBLE APPLICATIONS WILL N OT BE ACCEPTED

Name of Owner:

EMAIL:

Owner’s Address: Owner’s Cell Phone:

Emergency Contact

Name: Emergency Contact Phone:

Name of Dog: Breed of Dog:

Age of Dog: Approx Weight of Dog: Dog’s Veterinarian: Veterinarian Phone #: Collar Tag

Form of Dog’s ID (Circle One) Microchip

**Please bring this completed form along with a copy of vaccina�on records documen�ng current vaccina�ons for Rabies, Parvo, Distemper and Bordetella (Kennel Cough), along with payment to:

Greenwood Parks & Recrea�on Greenwood Community Center 100 Surina Way, Greenwood, IN 46143

& E�que�e: Use of the Greenwood Parks Dog Parks are not a right, but is a privilege Please do not allow unacceptable or irresponsible behavior to ruin the experience for others. The Greenwood Parks Dog Parks strive to provide a fun environment for owners and their dogs By using the Dog Parks, users must understand that they assume all responsibility and liability for the risks of unleashing their dog(s) in this facility. Greenwood Parks Dog Parks are not a supervised facility. Users therefore are required to abide by the rules and etiquette at all times while on the premises. Own ers and individuals accompanying them use the facility entirely at their own risk and that of their dogs. The future of th ese facilities and others like it depends on members behaving responsibly and obeying all the rules. Canines and their owners are expected to b ehave with common courtesy and respect for the property as well as other park users. We realize that owner socialization is a great added value to the experience, but please remember that the dog owner’s first priority is the proper supervision of his/her dog.

Greenwood Dog Park Membership Rules