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2. First Name*
3. Last Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
12. Email Address*
14. Is the mailing address different than the address above? *

    1. No
    2. Yes
16. Mailing Address
18. City
19. State
20. Zip Code
24. 1st Dog
26. Name*
27. Breed
29. Sex

    1. Male
    2. Female
30. Rabies*

    1. Vaccine Current
32. Do you have multiple dogs? *
    -- Select One --NoYes, I have 2 dogs.Yes I have 3 dogs.
34. 2nd Dog
36. Name*
37. Breed
39. Sex

    1. Male
    2. Female
40. Rabies*

    1. Vaccine Current
42. 3rd Dog
44. Name*
45. Breed
47. Sex

    1. Male
    2. Female
48. Rabies*

    1. Vaccine Current
52. Pass Fee as of August 1, 2023*

    1. Resident of Orono (Must live within city limits)= $20.00

    1. Non-Resident = $27.50
56. Assumption of Risk and Liability

    Acceptance of the terms and conditions of this release and adherence to Off-Leash Area Rules are conditions of permit approval, retention and renewal. Permits may be revoked for noncompliance I hereby acknowledge that I voluntarily have applied to participate and use, with my dog(s), the Off-Leash Park (OLP) designated by the city of Orono (City). I understand that the acts of unleashing my dog(s) or being physically present inside an OLP necessarily involves risks of injury to me, other people, my dog(s) and other dogs, including but not limited to, risks resulting from aggressive or dangerous dogs, unpredictable behavior, lack of training, and lack of vaccination. I also assume responsibility of picking up my dogs waste and properly disposing. I expressly assume these risks and responsibility for the actions of my dog and myself. I understand that no agent or employee of the City will supervise the OLP at any time. I further understand and agree that the City is not liable for any loss, damage, or injury of any kind sustained by any human or dog while using an OLP. I therefore expressly assume all risks associated with using an OLP, as well as any fixtures or equipment located therein. I understand there will be a $5.00 fee for a lost or replacement pass. By signing this release of liability and using an OLP, I hereby fully and forever release and discharge the City, its employees and agents from any and all claims, demands, damages, or causes of action present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my intended use of said OLP premises, facilities, or equipment. I understand that as a prerequisite to purchasing an OLP permit, I am required to have my dogs vaccinated for Rabies. I have carefully read this release of liability and understand, agree with and accept its terms and conditions. I also have reviewed a copy of the rules for use of the OLP and agree to abide by these rules.

58. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
60. Electronic Payment Agreement*

    I acknowledge a convenience fee of 3% will be applied to credit/debit card payments. An additional fee of 50¢ is applied for payments below $100.

    1. I agree
    2. I will pay via check/cash. Make check payable to: City of Orono. Payments can be dropped off at City Hall or mailed to: 2750 Kelley Parkway, Orono, MN 55356..
62. Electronic Signature*
63. Date*
    Date
65. Application is not complete until payment is received.

    Upon submittal of this form, you will be prompted to the payment screen. Off leash pass will be mailed after payment is received and approved.  If you choose to send payment via check/cash, you may close out after hitting Submit.  Thank you!

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67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit

* indicates a required field