Release and Indemnity Agreement

Rikki's Refuge - a no-kill all species peaceful sanctuary - PO Box 1357, Orange VA 22960 - 540-854-0870 - www.rikkisrefuge.org

Rikki's Refuge is in the wilderness, surrounded by nature, and it is home to animals of all species. Don't forget -- animals lurking in the woods can be dangerous: lions and tigers and bears (oh my!), animals that creep and animals that growl.. And don't forget the fleas and the bees! And watch out for that falling tree - we have lots of beavers. Frightened cats will scratch and startled dogs will bite. Poison ivy may climb where you least suspect. If you bring children or pets, be careful for them too. Watch out - take caution - and when in doubt, please ask. And remember, as when entering any wild and animal filled territory -- you're on your own. Good luck and enjoy your stay!

And now, whether you are a visitor to, or volunteer, or prosepctive employee or part time employee or full time employee at Rikki’s Refuge, you’ll need to agree to some things before you take part in this great venture. Once you sign it, this release will continue in effect each time you visit or volunteer or while you are employed.

I am 18 years of age or older. I accept full responsibility for my dependent children and/or animals and shall keep my children and/or animals under my own supervision at all times. I certify that any animals I bring onto Rikki’s Refuge are healthy and current on all necessary vaccines, excluding rescued animals that I am bringing to release into the custody of Rikki's Refuge.

I agree to cooperate with any conditions placed by Rikki’s Refuge on my activity as a visitor or volunteer or employee, including but not limited to fire safety, alcoholic beverages and environmental protection. I understand that Rikki's is a Zero Tolerance Drug Free Property and that no drugs use or possession what so ever will be tolerated. I understand that for the safety of the animals I may not light or smoke tobacco in any form on refuge property.

I agree to abide by all rules pertaining to the care and handling of any animal(s) under the auspices of Rikki's Refuge. I will not attempt to try to handle, pet, pick up, feed or interfere with any animal(s) at any time unless I have the authorization and the skill level to do so.

I assume all risks of any injury, including, but not limited to, any harm from any animal to me, my children, my animals and my property that may happen as a result of my visit, stay or employment at Rikki’s Refuge or as a result of any volunteer or paid work I may do on behalf of Rikki’s Refuge, whether or not that volunteer or paid work takes me to a location other than the refuge.

I release, remise, discharge and indemnify the owners of Rikki's Refuge, Life Unlimited of Virginia, Inc. and their respective agents, including any employees, volunteers or directors, from all claims, demands, actions and causes of action for injuries sustained by me and/or my dependent children and/or animals while doing anything, volunteer work, paid work or otherwise, at the Refuge or at any other location for, or on behalf of, Rikki's Refuge and/or Life Unlimited of Virginia, Inc. today or at any time in the future.

I agree that Rikki’s Refuge and/or Life Unlimited of Virginia, Inc. shall have no liability to others for any injury to any other person or property caused by me, including but not limited to automobile accident while using my vehicle as a volunteer or employee, or any injury caused by machinery of any sort.

I understand that any intentional damage I cause to the animals or property of Rikki's Refuge, or its employees, volunteers or visitors will be cause for legal action against me.

I understand that photos and/or videos may be taken and stories may be written for newsletters (electronic or printed) or advertising, in which I and/or my dependants appear and I relinquish all rights thereto to Rikki's Refuge and Life Unlimited of Virginia, Inc. to use said material in anyway they deem appropriate.

I expressly agree that this Agreement and Release shall be under the laws of the State of Virginia and that if any portion of this Release and Indemnity Agreement is held invalid, the balance shall, notwithstanding, continue in full legal force and effect.

I have read and understand the foregoing request, release and indemnity agreement and agree to it.

Date: Date:

Signature: Signature:

Name: Name:

Dependent Children and/or Animals:

Address: City: State: Zip:

Phone 1: Phone 2:

Fax: E-Mail:

RIKKI'S REFUGE IS SUPPORTED SOLELY BY DONATIONS - FROM KIND AND LOVING PEOPLE LIKE YOU

IF YOU ENJOY YOUR VISIT - PLEASE LEAVE A DONATION TO HELP FEED THE ANIMALS