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Sample Workplace Participant Pledge to Make Sure Pets Work at Work 

Use a participant pledge to ensure employees who take part in your pet-friendly workplace program understand the rules and expectations for them and their pet. As with your pet policy, you’ll want to review the pledge with your legal counsel to be sure it meets all the needs of your particular organization.

WORKPLACE PARTICIPANT PLEDGE

We’re excited you want to bring your pet to work! We understand that having your pet with you can boost your mood, help you connect with more people, and help encourage regular walking breaks that are good for you and your pet. We hope these combine to help you be even happier and more productive at work.

By completing this form to participate in our pet-friendly workplace program, you affirm that the information submitted below is correct and you take all responsibility for the behavior, health and actions of your pet for any and all time it spends at [ORGANIZATION].

About You

  • Name
  • Department
  • Phone and email
  • Location

About Your Pet

  • Pet name
  • Pet type
  • Pet gender
  • Pet age
  • Pet description

Health and Behavior

Please confirm the following statements:

  • My pet is up to date on vaccinations and I will continue to maintain current vaccinations as required by local law.
  • My pet is free of communicable diseases, parasites, fleas and worms.
  • My pet is well-trained, socialized and does not have a history of biting, excessive barking, chasing or aggressive behavior.
  • My pet is house-trained and I will immediately clean up any accidents that might occur.
  • I have homeowners/renters insurance that covers pet bites and does not include any breed specifications that my pet does not meet.
  • I agree to control my pet at all times and be 100% responsible for my pet’s actions.
  • I have read and agree to the [ORGANIZATION] pet policy.

Waiver of Liability

I, _______________, understand that participating in a pet-friendly workplace program comes with certain risks, including my own physical or psychological injury, pain or suffering, and that of the people who work around me. I assume all risks of my participation, whether known or unknown to me, and take legal and financial responsibility for all consequences.

I unconditionally indemnify and agree to hold harmless [ORGANIZATION], its management, directors, shareholders, partners or agents, as well as its landlord [NAME], from any and all loss, damage, liability and expense, including court costs and attorney fees, that may result from bringing my pet to work with me at [ORGANIZATION].

This includes injuries, death, property damage or any other issues, whether caused by me, my pet or by anyone else including coworkers, guests or others, whether due to the negligence of [ORGANIZATION] or otherwise.

I also acknowledge that [ORGANIZATION] may revoke its permission to bring my pet onto its premises at its sole discretion for any reason and at any time without notice, including but not limited to, the health, safety, and comfort of my fellow employees/co-workers, especially where required by law. I also acknowledge that the organization may do so without revoking such permission to others.

By signing this form, I agree that I have read this document completely and understand the legal consequences of signing it, including assuming all risk of participating in the pet-friendly workplace program.

 

Signature of Employee
Date

 

Signature of Supervisor
Date

 

Want more tips? Check out the Pets Work at Work Toolkit for info about how to start and maintain a successful pet-friendly workplace program.

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sample participant pledge