I have read and agree to all of the following:

1. I certify that I am 18+ years old and the legal owner or authorized agent for the owner of the pet described above. I hereby give my permission for my pet to be cremated.

2. I understand that my animal is to arrive in a box, bag, or wrapped in a blanket or towel.

3. I understand that payment is due in full before services will be rendered by WVHS. I further understand that all payments are final. Refunds will not be issued for any reason by WVHS.

4. I understand that I am to pick up my pet's remains at the time specified and I understand that if I fail to do so, I will be liable for storage fees. I also authorize WVHS to dispose of my pet's ashes if I fail to pick them up within 2 weeks of notification that they are ready for pick up.

5. I agree to indemnify and hold harmless the West Valley Humane Society, the attending veterinarian, and any of the officers or employees of said entity from any and all claims, damages and causes of action that may arise from the procedures or operations to be rendered.

6. I agree to indemnify and hold harmless West Valley Humane Society, the attending veterinary, veterinary technician, and any other WVHS employees from any and all liability arising out of the performance of all procedures during my visit.