Owner_____________________________
Telephone_________________Vet_________________
Address___________________________________________________________________________
Breed_______________________________Age_________ Sex___ Spray/Neutered__yes/ no_
Immunization Record (latest date)
Color__________________________________
Dogs Cats
Rabies_______
Rabies_______
DLPP_________
FeLV_________
Has our dog ever been kenneled before Yes or
No
Is your dog aggressive to other dogs
_________________________________________________
Special
Instructions_________________________________________________________________
Does
your pet have a medical conditions? If yes explain
___________________________________
Is your Animal on a flea preventative
__________________________________________________
Is your dog on heartworm medications? Yes or No
This is an agreement between
______________________________________(Stonewall Boarding)
And the pet owner whose signature appears below
(hereinafter called “Owner”).
1) Owner agrees to pay the rate for pet care provided in effect on the date pet is checked into Stonewall Boarding.
2) Owner further agrees to all costs and charges for
special services requested, and all veterinary costs for the pet during the
period said is in the care of Stonewall Boarding.
3) Owner further agrees that the pet shall not leave the
facility until all charges due are paid by owner or proper payment arrangements
are agreed upon by both parties.
4) By Signing this agreement and leaving pet with Stonewall
Boarding, Owner certifies to the accuracy of all information given about said
pet. Stonewall Boarding reserves the right to deny admittance to Owners pets for
any reason at any time.
5) Stonewall Boarding shall exercise reasonable care for
the pet delivered by the owner to the pet care provider. If interactive daycare
is provided, Owner recognizes and accepts potential risks involved in such
activity. It is expressly agreed by Owner and pet care provider that Stonewall
Boarding liability shall no event exceed the lesser of the current chatted value
of a pet of the same species or the sum if $400.00 per animal admitted. The
Owner further agrees to be solely responsible for any and all acts or behavior
of said pet while it is in the care of
6) the pet care provider, to include payment of costs for
injury to staff or other animals or damage to facilities caused by the pet.
7) Owner specifically represents that he or she is the sole
owner of the pet, free and clear of all liens and encumbrances.
8) Owner specifically represents to Stonewall Boarding
that, to Owner’s knowledge, the pet has not been exposed to any contagious
diseases within a thirty-day period prior to check-in. During the period of this
agreement, Owner also agrees to notify Stonewall Boarding of any exposure of pet
to a communicable disease and hold pet out of attending Stonewall Boarding until
pet is symptom-free for a minimum of 10 days or with written veterinary
clearance. Owner further agrees to maintain currency of vaccinations as required
by Stonewall Boarding policy.
9) All Charges incurred by Owner shall be payable upon
pick-up of pet, or when billed by Stonewall Boarding at address listed on
contract. Stonewall Boarding shall have, and is hereby granted, a lien on the
pet for any and all unpaid charges resulting from services provided by Stonewall
Boarding. The owner here by agrees that in the event the charges are not paid
due in accordance with this contract Stonewall Boarding may exercise its lien
rights upon ten days written notice given by Stonewall Boarding to Owner by
certified mail to address shown on contract. Stonewall Boarding may dispose of
the pet for any and all unpaid charges, at private or public sale, in the sole
discretion of Stonewall Boarding and Owner specifically waives all statutory or
legal rights to the contrary. If such sale shall not secure a price adequate to
pay such costs of pet care or other charges delinquent, plus costs of sale ,
then Owner shall be liable to Stonewall Boarding for the difference. All monies
realized by Stonewall Board at such sale, over and above the charges due costs
of sale, shall be paid by to Owner.
10) If pet
becomes ill or injured, or if the state of the animal’s health otherwise
professional attention, Stonewall Boarding, in its sole discretion, may engage
the services of a veterinarian or administer medicine or give other requisite
attention to the animal, and expenses thereof shall be paid by Owner.
11) This
Agreement contains the entire agreement between the parties. All terms and
conditions of this agreement shall be binding on the heirs, administrators,
personal representatives and assigns the Owner and Stonewall
Boarding.
12) Any
controversy or claim arising out of or relating to this agreement, or the breach
thereof, or as the result of any claim or controversy involving the alleged
negligence by any party to this agreement, shall be settled in accordance with
the rules of the American Arbitration Association, and judgment upon the award
rendered by an arbitrator may be entered in any Court having jurisdiction
thereof. The arbitration shall, as part of the award determine an award to the
prevailing part of the costs of such arbitration and reasonable attorney's fee
of the prevailing party.
Signatures:
Stonewall Boarding Inc______________________________Owner
______________________Date_____