From this point on, any business or individual signing this form is termed “member.” A membership term is dated from the time of payment for the number of years specified.  For instance, if you sign and pay the initial membership form on July 4, 2009, your membership is in force from that date until July 4, 2011. Renewal fees are for extended time frames, at a reduced yearly cost. Hiway Dog reserves the right to contract large franchises and corporations for extended time periods, for reduced rates.

I hereby agree to adhere the rules and by-laws set down by the Hiway Dog Program.  The goal is to provide a safe stop, shaded parking and designated potty location. More amenities are encouraged and each business can customize the program according to locale. I understand that the Hiway Dog program offers only a promotional service.

By signing this form you indicate that you agree and understand the following:

• Members are permitted limited use of the Hiway Dog logo on in-house promotions.
• Members will allow unannounced visits by Hiway Dog members and personnell to verify they are providing the ammenities they advertise.
  
• Members must maintain safe, clean areas suitable for pets and their people.
• Members must use the provided standard logo for ALL signs and advertising without any modifications.
  
• Membership enrollment is for a specified time period, as agreed to at this signing.
• Members can not hold Hiway Dog responsible for any losses or injuries sustained on member premises, or as a result from sponsored events. Member further agrees to idemnify and hold Hiway Dog harmless from any claims or demands rising out of such claims or losses.
• The Hiway Dog symbol will not be used in a means that is derrogatory or harmful to the program or other participants in the program
• Any assistance and support from members, that has a positive affect on animal rescue or humane organizations, will be applauded and encouraged by this program.
• Member membership status can be revoked or suspended if these rules are broken, or program standards are not met.
• Members agree to allow photographs or videos to be taken on their premises, to be used for marketing applications promoting the Hiway Dog program.
• Only one address or location per membership, unless otherwise negotiated with Hiway Dog.

I authorize my bank to release the amount on my authorized check to Hiway Dog, for the membership term indicated below.

Choose appropriate fee for initial TWO YEAR MEMBERSHIP. 

This INTRODUCTORY PRICE available until December 31, 2010.

• Business with 1-20 Employees: $79
• Business with 21-50 Employees: $195
• Business with 50+ Employees: $495

        

REGULAR PRICE FOR TWO YEAR MEMBERSHIP WILL REVERT BACK TO THE FOLLOWING ON JANUARY 1st, 2011.

• Business with 1-20 Employees: $250 
• Business with 21-50 Employees: $500
• Business with 50+  Employees: $1,200

Business/Member Name: ________________________________

Location: _____________________________________________

Billing/Contact Address: _________________________________

City: ___________________  State: _______  Zip: ____________

Email: ___________________   Contact Person: ______________

Date:  ___________________   Signature:   __________________

 

Length of Membership:___________________

YOU MAY PRINT OUT THIS FORM and mail with check to:

Hiway Dog

N8060 Cty Rd J 

Menomonie, WI 54751

or Call 715 642-2999 to set up a Paypal payment.

 

A representative will contact you, asking if you would like to purchase available metal signs and answer any questions. We provide a TM graphic that you may use on your advertising and order your custom signs from your local sign maker.  Our sign costs are based on the size of signs you require. Call 715 642-2999 if there is anything else we can assist in.