MANDATORY IN-PERSON REGISTRATION AT:

Registration Packet Limited annual memberships will be for sale to residents Thursday, Sept. 4, 2014. Non-resident registrations, pending availability, will be Wednesday, Oct. 1. MANDATORY IN-PERSON REGISTRATION AT: Community Recreation Center 505 N. Springinsguth Road Schaumburg, Illinois 60194 Tel: 847/490-7020 Fax: 847/490-2498 120 Remington Road, Schaumburg www.parkfun.com

Welcome Thank you for becoming a member of Schaumburg Park District s K-9 Park. Please read and complete the registration section of the following welcome packet. Registration: Resident registration begins Sept. 4, at the Community Recreation Center, 505 N. Springinsguth, Schaumburg. Non-resident registration begins Oct. 1, 2014. In-person registration is mandatory. Current vaccination records are mandatory for registration. All dogs must have current vaccinations for rabies, distemper, leptospirosis, parainfluenza, hepatitis and parvovirus. Registrations will not be processed without current vaccination records from your veterinarian. Registrations will not be reserved. No registrations will be processed by phone or online. Key Ring Tag Access: You will receive a key ring tag to access the park at the time of registration. Do not provide access to anyone who does not have a dog tag or registered dog. If your dog s vaccinations expire within the year, please forward updated records to the Park District via fax, mail or in-person. Failure to submit updated vaccination records will result in deactivation of your key ring tag within 30 days of vaccination expiration. Your key ring tag will be reactivated when membership is renewed. Please do not destroy or write on the dog tag. Key ring tags will be reused. Lost or damaged key ring tags may be replaced for $10 at the Community Recreation Center, 505 N. Springinsguth Road, Schaumburg, 847/490-7020. Key Ring Tag Problems: If your key ring tag does not work, please report it to the Schaumburg Park District at 847/490-7020. You must re-register annually with the Park District to ensure your key ring tag works. Be sure your dog s vaccination records are up-to-date. You cannot re-register your dogs without proof of current vaccinations.

Rules, Regulations and Etiquette Please be courteous to other dog owners. Please become familiar with the following Rules, Regulations and Etiquette on how to use the dog park. 1) You must purchase an annual permit membership at the Schaumburg Park District to use the Schaumburg K-9 Dog Park. Proof of current vaccinations are required. Memberships are available to residents and non-residents at the following rates: Annual Fee:... Resident: $60 park fee/$10 key ring tag fee/$10 per additional dog (limit of four dogs total, per owner) Non-resident (if available): $110 park fee/$10 key ring tag fee/$20 per additional dog (limit of four dogs total, per owner) Renewal:... $60 for residents and $110 for non-residents. No additional tag fee if key ring tag is undamaged. Replacement Key Ring Tags:... $10 2) K-9 Park Hours: 7 a.m. to 11 p.m. Dogs over 30 pounds must use the large area. Although not recommended, small dogs also may use the large dog area. 3) The agility area is open to large and small dogs. 4) Maximum two dogs per adult at the park. Both dogs must remain in the same run area with their owner. Large dogs (30 pounds and up) are not allowed in the small run area. 5) Dogs must remain leashed until they are inside the small or large run areas. For the safety of all dogs, no prong or pinch collars are allowed in the run areas. Leashes must be removed once in the park. If you are uncomfortable with your dog off the leash, please reconsider your visit to the park. 6) Owners must supervise their dog(s). Know where your dog is at all times and keep your leash at hand. 7) Dogs that are unruly toward other dogs must be removed immediately. 8) If your dog injures another dog or owner, give your name and phone number to the injured party. You are legally and financially responsible for your dog s actions and any harm caused to others or damage to property. See Dog Incident Policy attached. 9) Pick up your dog s droppings and any orphaned droppings. Carry extra bags with you. Bags and waste receptacles are available.

Rules and Regulations Continued 10) A handler must be age 18 or older and present at all times. The handler is solely responsible for the actions of their dog(s). Children between the ages of 11 and 17 are not permitted within the dog park unless accompanied by an adult. Children under 11 are not allowed in the park. 11) Dogs must display a current rabies tag and K-9 Dog Park colored dog tag. 12) Dogs in heat are not allowed in the park. 13) Dogs who are unhealthy are not allowed in the park. Flea and tick treatment is recommended, particularly during spring, summer and fall. 14) Dogs which exhibit exploratory mating behaviors or aggression (including urinating on other animals or people) should be removed immediately from the park to avoid injury to other dogs and owners. Chronic or habitual offenders will lose their K-9 Dog Park privileges. 15) Do not allow your dog to run to the gate when another dog enters. The gate area must be kept clear at all times so members can enter and exit without incident. For safety reasons, do not congregate near the entrance. 16) Puppies under six months old are not allowed in the park. 17) No smoking, glass containers, food including dog treats, rawhide, bones and hooves, alcohol or soft drinks are allowed in the dog park. This is to ensure the park stays clean and to prevent dogs from begging for food or showing aggressive behavior. 18) Water is available at the park. Please bring your own container. 19) No human sports of any kind are allowed in the park (rollerblading, football, baseball, bikes, skateboards, ice skating, etc.). 20) Do not allow people or dogs in the park who do not have a key ring tag or K-9 dog tag. Encourage visitors to call the Park District for more information about the K-9 dog park. Report fence jumpers to the police at 847/882-3586 or dial 911. 21) K-9 Park will be closed for maintenance 7-9 a.m. on Mondays and Thursdays. 22) Dogs may use the pond area. The pond is not for human swimming, fishing or ice skating. Access to the pond is through the gated area only. 23) Professional pet trainers may not use the park to conduct business. 24) If lightning detection system is activated, patrons must exit the park. 25) Failure to comply with the above rules may result in revocation of your park privileges.

Emergency Telephone Numbers Golf Rose Animal Hospital 1375 N. Roselle Road Schaumburg 847/885-3344 Website: www.golfroseah.com Schaumburg Park District: Community Recreation Center 505 N. Springinsguth Road Schaumburg 847/490-7020 Village of Schaumburg Non-Emergency Police 847/882-3586 or dial 911

Dog Incident Policy Schaumburg Park District K-9 Park s Rules and Etiquette are designed to minimize the chance of dog incidents. Should an incident occur, the following actions are recommended: Separate and leash the dogs. Remove dogs to neutral area by main gate. Inspect dogs for injury. Exchange contact information between owners. Get names and phone numbers of any witnesses. If required, contact Animal Control, 847/882-3586 or dial 311. Cook County Animal Control requires all bites and scratches, either dog to dog or dog to human, to be reported within 24 hours. If an incident occurs, please call 911 so an officer can file the appropriate report. You are legally and financially responsible for the actions of your dog. See attached Waiver Form.

Dog Park Waiver and Release When this Waiver & Release refers to your dog, my dog, or the owner of a dog, it includes you whether or not you are the legal owner of the dog since you are the person responsible for the dog while using Schaumburg K-9 Park. Warning of Risk Dog activities are intended to provide a fun and rewarding experience for a dog and its owner/ handler. However, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury, including death to the dog, its owner/handler or other persons or animals. Dogs are pack animals and when off lead, even the best-trained dogs will act instinctively. Understandably, not all hazards and dangers associated with dog activities can be foreseen. Certain inherent risks include the propensity of any dog to behave in dangerous ways that may result in injury to you, another person or dog. Other risks include, but are not limited to, the inexperience, negligence or irresponsibility of a dog owner/handler; the inability to predict a dog s reaction to sound, movements, objects, persons, or other animals; and actions by the dog due to fright, anger, stress, insect bites or natural reactions such as jumping, pulling, resisting and biting. Other risks include the hazards associated with environmental and traffic conditions, acts of God, inclement weather, slips and falls, premises defects, equipment failure, failure in instruction/ supervision, and all other circumstances inherent to dog and/or outside activities. Should you attempt to break up a dog fight or restrain a dog, including but not limited to your dog, you may be attacked and severely mauled by your dog, the other dog or attacked by another dog s owner/ handler. In this regard, it must be recognized that it is impossible for Schaumburg Park District to guarantee absolute safety. Waiver and Release of All Claims and Indemnification Agreement Please read this form carefully and be aware that in consideration for permission to use Schaumburg K-9 Park, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your dog might sustain as a result of participating in any and all activities connected with and associated with use of Schaumburg K-9 Park and surrounding area. (continued on back)

Waiver and Release Continued I recognize and acknowledge that use of Schaumburg K-9 Park and the surrounding area for dog activities and participating in dog activities entails certain risks of damage, loss or injury to animals, persons or property (including to me, other persons, my dog and other dogs or animals), and I voluntarily agree to assume the full risk and responsibility for any injuries, damages, loss, liability, costs and expenses, regardless of severity, extent or amount that (a) I, my dog or any other person accompanying me might sustain or incur as a result of my presence in this facility and surrounding area or my participating in any and all activities connected with or associated with use of Schaumburg K-9 Park and surrounding area; or (b) any other person or animal might sustain as a result of my or my dog s actions or conduct in connection with or associated with use of this facility and surrounding area. I do hereby agree to waive, relinquish, release and forever discharge (a) the Schaumburg Park District, and its officers, directors, employees and agents, and (b) any volunteer assisting or working on behalf of the Schaumburg Park District or any of its officers, directors, employees or agents (hereinafter collectively the Parties ) from any and all claims or causes of action for injuries, damages, loss, liability or expenses that I may have or which may accrue hereafter to me or any other person claiming through me or on my behalf and arising out of, connected with, or in any way associated with the use of Schaumburg K-9 Park and surrounding area. I further agree to indemnify and hold harmless and defend (a) the Schaumburg Park District and its officers, directors, employees and agents, and (b) any volunteer assisting or working on behalf of the Schaumburg Park District or any of its officers, directors, employees or agents (including but not limited to court costs and attorney fees), occurring, growing out of, incident to, or resulting directly to indirectly from my use of this facility and surround area, including without limitation any losses, claims, damages, liabilities, cause of actions and expenses on account of personal injury to or death of any person or animal, or damages to property of any person or entity (including but not limited to the Schaumburg Park District). I HAVE READ AND FULLY UNDERSTAND THE ABOVE IMPORTANT INFORMATION, WARNING OF RISK, ASSUMPTION OF RISK AND WAIVER AND RELEASE OF ALL CLAIMS. Permit Holder s Name (Please Print) Permit Holder s Signature Date

Key Ring Tag Serial #: Registration Walk-in registration only at Community Recreation Center 505 N. Springinsguth Road, Schaumburg Resident Fee:... $60 first dog; $10 per add l dog (Max 4 dogs) Non-resident Fee:... $110 first dog; $20 per add l dog (Max 4 dogs) Key Ring Tag Fee:... $10 Replacement Fee: $10 Name: Address: City: Zip: Home Phone: Secondary Phone: Email: (Your email address will help us communicate updates to dog park users. We will never share your email with anyone else.) COMPLETE THIS SECTION. INCLUDE EACH DOG (max. 4 dogs per family). Attach a copy of vaccination records for each dog being registered. Schaumburg Park District requires the following vaccinations: Rabies, Distemper, Hepatitis, Leptospirosis, Parainfluenza and Parvovirus. These are all very standard vaccinations your dog should have. We strongly recommend Bordatella to help prevent the potential spread of Kennel Cough in Schaumburg. (1) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# FOR REFERENCE ONLY (2) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# (3) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# Must Register in-person at Community Recreation Center (4) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# o I have read and understand the Schaumburg Park District K-9 Dog Park rules. o I agree to provide updated immunization records if and when my dog s vaccinations expire in the current year. I understand that if I don t provide updated records, my key ring tag will be deactivated and will not be re-activated until I submit updated records. Print Name Signature Date IMMUNIZATION Rabies Distemper Hepatitis OFFICE USE ONLY EXPIRATION DATE IMMUNIZATION DOG 1 DOG 2 DOG 3 DOG 4 Leptospirosis Parainfluenza Parvovirus EXPIRATION DATE DOG 1 DOG 2 DOG 3 DOG 4 Total Paid: $ Check #: o Cash o Charge Accepted by: Date: White: SPD Copy Yellow: Member Copy Pink: Technology Copy