OUR MISSION STATEMENT:

• to provide a reptile educational service to the public and private;
• to prevent cruelty to reptiles;
• to effect social change in this area to ensure that reptiles are regarded as loving companions;
• to disseminate humane educational materials for reptiles;
• to provide emergency foster care for reptiles at risk, abuse and victims of domestic violence;
• to assist in finding loving and responsible homes for reptiles locally; 
• to provide it’s members an outlet to show-off their reptiles, communicate with other reptile enthusiasts, re-home reptiles, trade supplies, share stories, pictures and ideas, and enjoy their reptiles as they should be;
• to provide and regularly maintain a user-friendly, informational and resourceful web site advocating reptile awareness, club members, upcoming meetings/events, reptiles available for adoption, educational information and their well-being.

757-905-3417
E-mail VIIPER2008@yahoo.com to order stickers or ask any questions.

____________________________________________________________________________________________________________ 

MEMBER APPLICATION

Name ____________________________________________________________  Date  _________________________ 
City  _______________________________________ ST  ________  Zip  ______________ 
Phone (H) ________________________ (W) __________________________ (C) ______________________________
DOB ________________________
Email Address(s) ______________________________________________________________________________________
How did you learn about VIIPER? (Please indicate all that apply)
________Friend _______VIIPER Website _______ Internet _______ VIIPER Member (Who? ________________________)
________Local Event (Where? ____________________) _______Other (explain: )
MEMBER AVAILABILITY:
When are you available for events? Please indicate days:
_____Sunday _____Monday _____Tuesday _____Wednesday _____Thursday _____Friday _____Saturday _____Mornings _____Afternoons _____Evenings Other
Please check the activities that interest you most: _____ Care _____ Adoptions _____Fostering _____Medical Care _____Fundraising _____Marketing _____Newsletter _____Web Page _____Public Education _____Event Coordination ______Social Events ______Other

EMERGENCY CONTACT:
In case of emergency, whom should we notify? For your safety, please list two (2) persons:
Name________________________________________________  Relationship  ____________________________________ 
Phone (H) _______________________________ (W) ___________________________ (C)_____________________________
Address _______________________________________________________________________________________________

Name_________________________________________________ Relationship_____________________________________
Phone (H) _______________________________ (W) ___________________________ (C) ____________________________
Address _______________________________________________________________________________________________



Signature:_________________________________________________  Date: _______________________________________



Member Code of Conduct

I. I, __________________________________, while acting as a member of VIIPER understand that VIIPER is dedicated to improving the condition of reptiles through education, events, fostering and other means. In an effort to effectuate those purposes, there are policies and procedures I must follow for the efficient operation of VIIPER and for the benefit and protection of individual rights and the reptiles under VIIPER’s care.

II. I acknowledge and accept the following Code of Conduct and understand that my position as a member could be jeopardized if I do not adhere to these standards. I agree that I will not engage in the following conduct:

1 Discourtesy or abusive language or behavior to VIIPER officers/members, event personal or the public;
2 Uncooperative behavior with VIIPER officers/members, event personal or the public;

3 The negligent or intentional destruction of VIIPER property;

4 Violation of any safety rules or endangering the health or safety of any other person or reptile;

5 Participating as a member at a public event while under the influence of alcoholic beverages or illegal
substances;

6 Involvement in criminal activity that leads to, or has previously resulted in, a criminal conviction.


III. I understand and acknowledge that inappropriate conduct will result in disciplinary action at the discretion of the VIIPER Officers.

When I am acting in my capacity as a VIIPER member, I agree to be properly attired. This means, at minimum, I will wear a VIIPER shirt, shorts or pants in good condition and presentable footwear. In addition, I agree to wear a name tag provided by VIIPER for all public events.

I understand and acknowledge the importance of addressing with the VIIPER Officers any issues or concerns I may have regarding the policies and procedures or matters that I deem inappropriate.



Member Signature:_____________________________________________________ Date:_____________________________



Member Release of Liability and Hold Harmless Agreement

All VIIPER Members participating in any event or activity organized or sponsored, in whole or in part, by VIIPER, INC. are required to read, agree to, and sign this waiver before participating in any such event or activity. Please acknowledge that you have read each section by initialing where indicated.

1. Waiver of Liability for Services Performed On Site

I hereby release and forever discharge VIIPER, INC. and its officers, members and volunteers, from all liability for any and all claims, demands, actions, causes of action or suits of any kind whatsoever, and particularly on account of any injuries, to person or property sustained while performing services, voluntary or otherwise, at any event or function.
Initial Here: ______

2. Waiver of Liability for Services Performed Off Site

I hereby release and forever discharge VIIPER, INC. from all liability for any and all claims, demands, actions, causes of action or suits of any kind whatsoever, and particularly on account of any injuries, to person or property sustained while performing services, voluntary or otherwise, on behalf of, or in conjunction with, VIIPER, INC. , which occurs as a result of participation in any event or activity sponsored or endorsed by VIIPER, INC., including, but not limited to, any event or activity promoted in connection with VIIPER, INC. and travels to/from any such event.
Initial Here: ______

3. Responsibility for Personal Reptiles and Agreement to Indemnify

I agree that any injury, damage, or loss, of any kind whatsoever, to any VIIPER member, officer or volunteer, animal, or property at any VIIPER, INC. event, caused by my own reptile, or a pet which is otherwise in my possession, is solely my responsibility and I will indemnify, save and hold harmless VIIPER, INC. from any damages, costs, losses and expenses including, but not limited to bodily injury, property damage, including but not limited to legal fees, courts costs, and litigation expenses.
Initial Here: ______

4. Responsibility to Report Injuries

I agree to immediately report all injuries or disease I may receive while at a VIIPER, INC. event or while working in the service of VIIPER, INC., including but not limited to animal bites, deep scratches, and slips or falls. I agree to file an Incident Report immediately with a VIIPER Officer within 24 hours of the incident.
Initial Here: ______

5. Agreement to Indemnify

I further agree that if, despite this Release of Liability and Hold Harmless Agreement, I or anyone on my behalf makes a claim against VIIPER, INC., I will indemnify, save and hold harmless VIIPER, INC. from any damages, losses and expenses including, but not limited to, legal fees, courts costs, and litigation expenses.
I agree to indemnify and hold harmless VIIPER, INC. from any and all liability, damage, loss, cost and expense incurred as a result of any claim, demand or cause of action brought against VIIPER, INC., jointly or individually, for bodily injury, death or property damage suffered as a result of my own negligent, reckless or willful act, omission in the performance or failure to perform his/her volunteer services. (EXAMPLE: a member is drunk and driving their personal vehicle to a VIIPER Event and hits and kills a 3rd person. Estate of 3rd person sues VIIPER, INC.; the signer of this agrees to pay the judgment against VIIPER, INC. )
Initial Here: ______


6. Acknowledgements

Neither this waiver nor the circumstances leading to its execution shall be deemed an acknowledgement by VIIPER, INC. that, as of the date hereof, any such claim exists or will exist or that the activities and events of VIIPER, INC. are hazardous or present any unusual risks.
I acknowledge and agree that I: (a) fully understand the meaning of this Release and Waiver and recognize my right to seek the advice of an attorney before signing it; (b) have signed it freely and without any inducement or assurance of any nature; (c) intend it to be a complete unconditional release of liability to the greatest extent allowed by law; and (d) agree that if any portion of this agreement is held to be invalid the balance notwithstanding shall continue in full force and effect. The acceptance of this release shall not operate as an admission of liability on the part of anyone, nor as a waiver or bar with respect to any claim that I may have against the undersigned.
This release is binding on my heirs, executors, assigns and administrators. The undersigned is aware of the risks of attending, traveling to and participating in said events or activities and hereby assumes all risks. The risks include those foreseen and unforeseen, known and unknown.
Initial Here: ______

I hereby declare that I am over the age of eighteen (18) years old and that I have read and understood and voluntarily accept the terms and conditions of this Release of Liability and Hold Harmless Agreement. Members under the age of 18 will require a signature from a legal parent or guardian.

Print Name: ______________________________________________________ Date:______________________________

Signature: _________________________________________________________

VIIPER Officer’s Signature: __________________________________________
 
________________________________________________________________________________________________________________

Please complete, print  and leave with a VIIPER Officer or e-mail the same information to: VIIPER2008@yahoo.com.  
 
Or mail to:  VIIPER  Eric Crabtree Secretary  875 Dovercourt Rd Norfolk, VA 23518 

Monthly membership dues:  $10.00.
6 months of dues:  $50.00   
One Year:  $100.00       
VIIPER t-shirts are $15.00 each and required at regular events and shows.  
VIIPER polo shirts (embroided) are required for all major events and shows.
Black zip-up fleeces (embroided) can be ordered for $33.00 to $37.00 each.
Beenies (embroided) are $13.00.     

                             

E-mail VIIPER2008@yahoo.com