I understand that an emergency exists and that special arrangements have been made to allow my family and pet(s) to remain together in this shelter facility. I understand and agree to abide by the pet care rules contained in this agreement and have explained them to any other family member accompanying my pet(s) and me.

Rules:

1. My pet(s) will remain contained in its approved carrier except at scheduled times. During scheduled relief times, my pet(s) will be properly confined with leash, harness or muzzle (if necessary). Scheduled times will be strictly adhered to.

2. I agree to supply food and bowls for food and water.

3. I certify that my pet(s) is current on rabies and all other vaccinations recommended.

4. I will maintain proper identification on my pet(s) and its carrier at all times.

5. I will permit qualified animal shelter personnel/vet to administer medical care should it become necessary.

6. I acknowledge that my failure to follow these rules may result in the removal of my pet(s) to another location. I further understand that if my pet(s) becomes unruly, aggressive, shows signs of contagious disease, is infested by parasites (fleas, ticks, lice, etc.) or begins showing signs of stress related conditions, it may be removed to a more appropriate location. I understand that any decision concerning the care and welfare of my pet(s) and the shelter population as a whole are within the sole discretion of the shelter manager, whose decision is final.

7. I further understand that any damage caused by my pet(s) will be my responsibility. I certify that my pet(s) has no previous history of aggressive behavior and has not been diagnosed with any contagious disease for which it has not received successful treatment. I hereby agree and hold harmless all persons, organizations, corporations, or government agencies involved in the care and sheltering of my animal(s). I further agree to indemnify any persons or entities which may have suffered any loss or damage as a result of the care and sheltering of my animal(s).

Part 1

All residents living in the qualified areas must pre-register their families and their center acceptable pets (a maximum of three). An adult who will be sheltering at the Pet-Friendly Hurricane Evacuation Center (PHEC) with his or her pet(s) can call the Monroe County Emergency Management at 305-299-6018 to receive an application packet by mail, or the applicant can complete the online packet and mail it to the address provided. Required information will include:

• Cellular phone number.
• Daytime phone number.
• Description of carrier/cage.
• Description of pet(s) including gender/breed/coloring and weight.
• Evening phone number.
• Home address.
• Medical history of pet including all current medication.
• Name of each family member sheltering at the Center.
• Name of pet(s).

• A tentative acceptance letter.
• Part 2 of the application which must be completed in its entirety.

• Part 2 of the application, completed and notarized.
• A photocopy of the most recent utility bill that reflects the home address provided on the
• application.
• A picture of each pet being registered (minimum size of 3 inches by 5 inches).
• A photocopy of a picture identification of the adult registering/sheltering at the PHEC.

• State of Florida Driver’s License
• Current United States Passport
• State of Florida Identification

(If different from above)

The information above will be provided to the animal handler for scheduling medication administration.

I agree to read all information and follow all instructions as detailed on this registration form. I understand that failure to do so will preclude my and/or my family’s, and my pet’s(s’) acceptance. At the end of each paragraph or section there is a box that must be checked acknowledging that you read, understood, and agree to abide by the provisions therein. This form must be completed in its entirety.

This form must be signed (Digital signature accepted) and dated by an adult who is reporting to the PHEC for sheltering. It is the responsibility of the registrant to assure receipt of this form by the Monroe County Emergency Management. This may be done by calling 305-289-6018.

The information that I provided during my registration is accurate and complete. I understand that only those family members and pets pre-registered are allowed into the PHEC.

I agree to notify Monroe County Emergency Management as soon as possible of any changes in my registrant status. I understand that any changes, additions or deletions, either of persons or animals, must be made prior to a hurricane warning being issued for any one storm.

I understand that to gain entrance into the shelter I must reside in one of the mandatory evacuation zones. If my residence changes to an area outside a mandatory evacuation zone, or if I am no longer residing in a home that has been deemed unsafe by Monroe County, I understand that I (and my family and pet(s)) will no longer be eligible for sheltering at the PHEC.

I understand that to gain entrance into the PHEC. I must arrive at the PHEC with all items outlined in the tentative acceptance letter that accompanied this form.

My animal(s) are in good health. I understand that even though pre-registered, if my pet(s) is deemed a health or safety risk to any person or animal, entrance will be denied. This includes flea or tick infestation or any active parasitic or fungal infection such as ringworm or mange. I agree to my pet being examined by qualified animal shelter personnel to determine its fitness for entry. I understand and agree that at all times, regardless of compliance with all requirements; Monroe County still retains sole discretion in accepting persons and pets to the PHEC.

My pet(s) will be current on all required vaccinations as noted on the acceptance letter. I will provide proof of all required vaccinations at check-in as well as current rabies tag(s) as required. I understand that failure to provide these items will preclude entrance into the shelter.

I understand and agree that at least 1 adult family member will reside in the shelter with the pet(s) at all times and that if at any time my pet(s) is(are) left in the shelter without at least 1 adult family member that the animal(s) is then considered abandoned and will be immediately surrendered to _______________.

I understand and agree that if for any reason my animal is left behind, it is thereby considered abandoned and I will be responsible for any and all fees, fines, or monetary remittance payable to _______________ under their adoption, reunification, or euthanasia policy.

I understand and agree that upon entrance to the PHEC access to the animal(s) is limited and will be allowed contingent upon the needs of the animals, _______________ staff, or PHEC staff.

I understand that the feeding, replenishing of water, and removal of waste materials from the cage is the responsibility of the adult family member. Immediately upon request of PHEC staff to report to the animal area, I will do so and perform any feeding, watering, or waste removal necessary.

I understand and agree that this PHEC registration program is not a sheltering contract and that there is no contractual, legal or equitable right to sheltering at the PHEC arising from completion and submission of registration documents or otherwise. I hereby agree to hold harmless all persons, organizations, corporations, or government agencies involved in the care and sheltering of my family, my pet(s) and myself at the PHEC and agree to waive any claim against such persons, organizations, corporations or government agencies involved in the care and sheltering of my family, my pet(s) and myself at the PHEC. I further agree to indemnify any persons or entities, organizations, corporations or government agencies which have suffered any loss, damage, or claim related in any way to the care and sheltering of my animal(s) at the PHEC. I also agree to undertake the defense of any claim against the County or other governmental agencies, organizations, or individuals arising out of the sheltering of a pet at the PHEC.