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 PILGRIM PINES

CAMPING AREA PET REGISTRATION & HEALTH CERTIFICATION FORM


NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of your participation in any activity related in any way to Pilgrim Pines Camp and Retreat Center, Camp Squanto, East Coast Conference of the Evangelical Covenant Church, Inc. (a CT corporation), and East Coast Conference of the Evangelical Covenant Church, Inc. (a NH corporation DBA Pilgrim Pines Conference Center) (collectively “Pilgrim Pines”), now or at any time in the future.

By signing below, I acknowledge and agree to the following:

  • Only domestic dogs and cats are permitted in the camping area. No other animals are allowed.
  • All pets must be registered with the camp office, and vaccination records must be available upon request.
  • Pets must wear a collar with identification, including owner name and phone number.
  • Pets must be kept on a physical leash at all times. Electronic or invisible leashes are not permitted.
  • A maximum of two (2) pets per campsite is allowed. Each pet must not exceed 60 lbs.
  • Pets may not be left unattended at any time.
  • Pets must be well-behaved. Aggressive, disruptive, or uncontrolled pets must be removed immediately.
  • I accept full responsibility for any injury, damage, or disturbance caused by my pet(s).
  • I agree to clean up after my pet(s) and properly dispose of all waste. I understand I may be charged for any cleanup costs incurred by the camp.
  • Pets are only permitted in the designated camping area and are not allowed in buildings, common areas, or amenities (including bathrooms, lodge, beach, fields, snack shack, and sports courts).
  • Pets are not allowed in rental units or bunkhouses.
  • Service animals are permitted in accordance with applicable laws and may require verification.
  • Failure to comply with this policy may result in removal from the property without refund.



By signing below, I acknowledge and agree that I am solely responsible for the care, supervision, and control of my pet(s) at all times while on the property of Pilgrim Pines.

I understand and accept that the presence of animals carries inherent risks, including but not limited to injury, property damage, or disturbance to other guests. I voluntarily assume all such risks associated with bringing my pet(s) onto the premises.

I agree to indemnify, defend, and hold harmless Pilgrim Pines, its directors, employees, volunteers, and affiliates from and against any and all claims, liabilities, damages, losses, or expenses (including legal fees) arising out of or related to my pet(s), including but not limited to:

  • Injury to any person or animal
  • Damage to property
  • Violations of local laws or regulations

I further agree that Pilgrim Pines shall not be held liable for any injury, loss, or damage to my pet(s), including illness, injury, escape, or death.

In the event that my pet(s) causes injury or damage, I agree to resolve the matter directly with the affected party and to cover any associated costs.

I acknowledge that failure to comply with camp policies or inability to control my pet(s) may result in immediate removal from the property without refund.


I HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE (a) Pilgrim Pines, East Coast Conference of the Evangelical Covenant Church, Inc. (a CT corporation), and East Coast Conference of the Evangelical Covenant Church, Inc. (a NH corporation DBA Pilgrim Pines Conference Center) and/or its staff, members, trustees, administrators, directors, employees, workers, volunteers, agents, officers, counselors, instructors, rescue personnel, (b) the owners and lessees of premises used to conduct the Activities, (c) the owners and lessees of equipment used in the Activities, or (d) other participants, campers, or persons involved in the Activities, all of whom for the purposes herein are referenced to as "Releasees," from all liability to me and/or the child[ren] named below, to the child[ren]’s parents or next of kin, personal representatives, assigns, heirs, for any and all loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in the death to my person or of the child[ren] arising out of or related directly or indirectly to the Activities, whether caused by the negligence of the Releasees or otherwise, including negligent rescue operations.      

I FURTHER AGREE that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my or the child[ren]’s behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as a result of such claim, whether the claim is alleged to have been caused by the negligence of the Releasees or otherwise. Further, any claims or disputes relating to the child’s participating in the Activities shall be venued in the Cheshire County Superior Court in the State of New Hampshire, and that New Hampshire law shall govern this agreement.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY AND AN ASSUMPTION OF THE DUTY TO INDEMNIFY TO THE GREATEST EXTENT ALLOWED BY LAW. I UNDERSTAND THAT I HAVE THE RIGHT TO CONSULT WITH AN ATTORNEY PRIOR TO SIGNING BELOW REGARDING THE LEGAL IMPLICATIONS OF THIS WAIVER.

I further certify that I am of lawful age and otherwise legally competent to sign this document. I further understand that the terms of this agreement are legally binding and certify that I am signing this agreement, after having carefully read it, of my own free will.

Today's Date: May 26, 2026

First Guest's Name
First Name*
Last Name*
Phone*
First Guest's Age Acknowledgment*
First Guest's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Guest's Signature*
Second Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Third Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Fourth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Fifth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Sixth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Seventh Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Eighth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Ninth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Tenth Guest's Name
First Name*
Last Name*
Guest's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Pet Information
Pet Name *
Pet Species*
Dog
Cat
Pet Breed *
Pet Color *
Pet Gender*
Female
Male
Pet Birthday *
Pet Weight *
Upload Pet Vaccination Records *
  
Valid file types: JPG, GIF, PNG, and PDF
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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