2019 NEW MEMBER

New Members - Please Note:

MHDRA requires written proof that the following three vaccinations are up to date:

Distemper/Parvo (DA2PP)
Rabies
Bordetella (kennel cough)
If you do not have proof of all three vaccinations do not send your application at this time.

Only complete applications will be processed.

Upload a JPG, PDF, or PNG providing clear up to date vaccination records from a licensed veterinarian, on her/his letterhead. NOTE: If Titers were used to assess immune response, we need a copy of those results for our records. A Titers Test may be given in lieu of the Distemper/Parvo--but never acceptable for rabies (by state law). On the health documentation, a vet's notation might refer to "Parvovirus Antibody level." MHDRA requires more: we need the test results as a ratio such as Titers 1.5. or Titers 1:5, or 1:4.

2. Upload a photocopy of your dog’s (dogs’) New York City / other locality license as a PDF or JPG. If you do not have a dog license - you can obtain one HERE

3. Submit the annual dues payment of $50.00 per dog. All major credit cards are accepted. Seniors (62 or older) may pay $25.00 per dog. If your application is not accepted, your payment will be refunded.

NOTE: The membership year is from January 1 through December 31. If you are applying late in the year, dues are not prorated.
Other Important Information:

Requirements for Anyone Bringing Your Dog to the Run
Even though your dog may be a member, no one may bring your dog into the run unless you have submitted and signed the Dog Walker’s Release Form. Every person bringing in your dog must have attended an orientation given by a board member. If you add or change a walker during the year this is necessary. You will be taken through those steps at the end of the application and must complete it before submitting.

Please Review the Code of Conduct
Please re-read these rules again. All members are not just expected to know them--but comply with them. The Code of Conduct and the governing By-Laws may be read on the website. If there are further questions, please contact us HERE

When your application is complete and approved by the Board, you will be contacted to schedule an Orientation. Depending upon demand and time of year, this may take several weeks. We are a volunteer organization, and sincerely try to do our best.

We look forward to welcoming you to our wonderful, clean, safe, and fun space!
Thank you.
Payment Information:
The MHDR is no longer accepting checks (snail mail). Payments are only accepted electronically at the end of this application.

Website terms and conditions

Please make sure that you read and agree to our website Terms and Conditions found HERE.
I understand and have all of the above requirements and agree to the Terms and Conditions*
- Start your Application

Owner Name*
First Last
Address*
Street Address City State ZIP Code
Primary or Home Phone*
Email*
Enter Email Confirm Email

Release Agreement

In consideration and as a condition of my being accepted as a member of MHDRA, being fully aware of the risks attendant thereto and assuming such risks, I hereby waive, release and discharge MHDRA, the members of its Board of Directors, its officers and employees and representatives (the MHDRA Releasees”) from any and all liability, claims, losses and expenses arising out of any injuries to person or property I may suffer as a result of canine behavior on MHDR property of any kind or nature, aggressive or otherwise, whether such animal is owned by me or any other person. I further acknowledge that any family member or guest on MHDR property at my invitation will be fully cognizant of the said risks attendant with such attendance and I warrant that I will make them aware of such risks.

In further consideration hereof, I hereby indemnify the MHDR Releasees from and against any liability, loss, damage (including but not limited to reasonable attorney’s fees) arising out of claims based upon the behavior and/or actions of any kind whatsoever by dog(s) owned by me.

No provision of the foregoing may be waived, altered or amended without express written consent of an authorized representative of MHDR.

By submitting the names below, I state:

1) that I have read and agreed to the Release Agreement above;

2) that I have read the rules of the run as described in the Code of Conduct and the By-Laws of the Association, and agree to abide by said Code and By-Laws; and

3) that I will not bring anyone under the age of 12 into the run.
I have read and understand the above release form*
- Confirm

Please provide the names of any additional household member who you are registering to bring your dog(s) to the run.

These registered household members must be 16 years or older. If you have non-household members, whether hired for pay or not, who you are authorizing to bring your dog to the run, you must complete the PROFESSIONAL DOG WALKER INFORMATION AND RELEASE FORM at the end of this application.
Number of Additional Household Members*
Name*
First Last
Alternate Email - Optional
Name*
First Last
Alternate Email - Optional
Name*
First Last
Alternate Email - Optional
Name*
First Last
Alternate Email - Optional
Due to insurance requirements, children under 12 are not permitted in the run under any circumstances. Children between 12 and 16 may enter the run when accompanied by one of the registered, adult (18 or older) household members listed
Does your household have children under the age of 12?*
- Yes
- No

How many dogs will use the run*
After uploading your dogs files - please click CONTINUE only ONE TIME and allow your files to upload. Larger files, will have a longer upload time.
ALL VACCINATIONS AND LICENSE MUST BE UP TO DATE AND YOU MUST FILL IN THE INFORMATION FIELDS FROM THE UPLOADED DOCUMENT
(if the information on the document and the information in the fields do not match, your application will be rejected)
Dog #1
Dog Name*
Sex*
- Male
- Female
Breed*
Veterinary Documents*
Please upload your Veterinary Documents - You must provide proof of all three required vaccinations
Accepted file types: jpg, png, pdf.
Date your dog received bordatella shot*
MM
DD
YYYY
Date your dog received rabies shot*
MM
DD
YYYY
Date your dog received DA2PP (parvo)*
MM
DD
YYYY
Dog License*
Please upload a photocopy of your NYC dog license or license application
Accepted file types: jpg, png, pdf.
Date your NYC dog license expires*
MM
DD
YYYY
Additional Document
Accepted file types: jpg, png, pdf.
Additional Document
Accepted file types: jpg, png, pdf.
Dog #2
Dog Name*
Sex*
- Male
- Female
Breed*
Veterinary Documents*
Please upload your Veterinary Documents - You must provide proof of all three required vaccinations
Accepted file types: jpg, png, pdf.
Date your dog received bordatella shot*
MM
DD
YYYY
Date your dog received rabies shot*
MM
DD
YYYY
Date your dog received DA2PP (parvo)*
MM
DD
YYYY
Dog License*
Please upload a photocopy of your NYC dog license or license application
Accepted file types: jpg, png, pdf.
Date your NYC dog license expires*
MM
DD
YYYY
Additional Document
Accepted file types: jpg, png, pdf.
Additional Document
Accepted file types: jpg, png, pdf.
Dog #3
Dog Name*
Sex*
- Male
- Female
Breed*
Veterinary Documents*
Please upload your Veterinary Documents - You must provide proof of all three required vaccinations
Accepted file types: jpg, png, pdf.
Date your dog received bordatella shot*
MM
DD
YYYY
Date your dog received rabies shot*
MM
DD
YYYY
Date your dog received DA2PP (parvo)*
MM
DD
YYYY
Dog License*
Please upload a photocopy of your NYC dog license or license application
Accepted file types: jpg, png, pdf.
Date your NYC dog license expires*
MM
DD
YYYY
Additional Document
Accepted file types: jpg, png, pdf.
Additional Document
Accepted file types: jpg, png, pdf.

Your Application is almost complete!
The dog run is a cooperative organization, and relies upon volunteer participation—in addition to your everyday responsibilities to keep the run clean and safe. Please indicate how you are willing to volunteer (select all that apply):*
- Ongoing Clean Up and Trash Removal
- Tennis Ball Aquisition
- Board Membership
- Other
Other*
Signature*
Before your application is complete - you must indicate whether or not you have a dog walker or a friend/sitter who will need to have access to the run.

In order for your application to be processed - you will need to submit a payment for your yearly dues. Renewals may only be done with a credit card and by completing this online form. Cash or check payments are not possible./p>
Do you need to submit a Dog Walker Application Form?*
Select "yes" if you have a dog walker or a friend/sitter who will walk your dog(s) and needs access to the run.
- Yes
- No

Dog Walker Information
Dog Walker's Name*
First Last
Dog Walker's Address*
Street Address City State ZIP Code
Dog Walker's Phone*
Company affiliation (if applicable)
Company phone # if applicable

I am a senior over the age of 62*
- yes
- no
The MDHR provides a membership discount on yearly dues for seniors over the age of 62
Senior Yearly Renewal*
Please enter the NUMBER OF DOGS you are paying for below. The $30 is cost per dog.
Price: $30.00 Quantity:
Regular Yearly Renewal*
Please enter the NUMBER OF DOGS you are paying for below. The cost is $60 per dog.
Price: $60.00 Quantity:
Total Renewal Cost
$0.00
Credit Card - please enter with no spaces*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Step 1 of 11

New Members - Please Note:

MHDRA requires written proof that the following three vaccinations are up to date:

Other Important Information:

Payment Information:

Release Agreement

Dog #1

Dog #2

Dog #3

Dog Run Member Questionnaire

Your Application is almost complete!

Dog Walker Information

Questions?