Paws and Pages Request Contact InformationName* First Last Phone*School NameSchool Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Participant InformationGrade LevelGrade level of readers.AgeAverage age of readers.Number of Participants*Please enter a number from 1 to 20.Maximum of twenty participants.Desired Dates*Please list 5 week day dates (Tuesday – Thursday) that will work for your group. Date will be chosen at our discretion.AgreementsPlease the statements below and check each one that you agree with.Agreements* Dress Code: For safety reasons, participants must wear closed-toed shoes and long pants. Sandals and flip flops are not permitted. Chaperones: Each group must have 1 chaperone per 5 participants. HSSA staff is not responsible for chaperoning the group. Cancellation or Absence: The HSSA Paws and Pages school program is an hour long commitment. We can’t guarantee a group can be rescheduled in the case of a group cancellation. Guests: Friends and family are not permitted to participate in the HSSA program with participants. Participants who wish to show their families and friends the facility are encouraged to visit the HSSA during shelter business hours, and only the areas open to the public. Safety: For the safety of animals and participants, participants will not be permitted inside the kennels. All reading and interaction will take place outside of the kennels. I hereby certify that I have read and agree to the conditions set forth above.