Graced Animal Services & Kennel

Name

First Name Last Name

Cell Phone Number

Area Code Phone Number

Home Phone Number

Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email

example@example.com

Emergency Contact (Name of person)

Emergency Contact Phone Number

Area Code Phone Number

Would you like to receive reservation confirmation and special offers via text message?

If yes, please write down your service provider.

Please list any others who may pick up your pet:

Pet Name

Pet Type

Dog Cat

Sex

Male Female

Spayed/neutered

yes no

Color and Markings

Approximate date of birth

Veterinarian Name

Veterinarian Phone Number

Area Code Phone Number

Check any/all that apply

If allergies indicate type(s)

Injuries, arthritis, recuperating from surgery (please indicate)

Special Instructions related to above condition(s)

The following are our vaccine requirements for every animal entering our facility.

Dogs: DHPP and DHLPP (also known as Da2PP)

Brdatella AKA Kennel Cough

Rabies

Cats: FeLV

FVRCP

Rabies

*All vaccines must have been given at least days prior to entering our facility

* All animals must be old enough to receive all of the above vaccines whixh is usually 12-16 weeks of age

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Client agrees to pay the rate of boarding in effect on the date the pet is checked into the kennel.
Client agrees to pay all costs for special activities requested and all veternary costs for the pet during the time pet is in the care of GK.
Client agrees that the pet shall not leave the kennel until all charges are paid in full to GK.
If pet becomes ill, injured, or if the state of the animal's health otherwise requires professional attention, GK, in its sole discretion, may engage the services of a veternarian or administer medicine or give other requisite attention to the pet, and the expenses thereof shall be paid by the client.
The kennel shall exercise reasonable care for the pet delivered by the client to GK boarding or grooming.
All charges incurred by the client shall be payable upon pick-up of pet. GK shall have, and is hereby granted, a lien on the pet for any and all unpaid charges. GK may exercise its lien rights upon 10 days written notice to owner by certified mail to address shown on permanent record. GK may dispose of pet for any and all unpaid charges at private or public sale or any method GK deems appropriate, in the sole discretion of GK, and the client specifically waives all statutory or legal rights to the contrary. Client is still liable for previous charges.
Client understands that GK cannot be held responsible for lost, dirty, damaged, or destroyed belongings.
Clients specifically represents to GK that pet has not been exposed to contagious diseases withing 30 days prior to said services, furthermore said pet is current on all required vaccinations and can be confirmed by the veterinarian listed on card. It is the responsibility of the client to ensure that GK has current vaccination records on the pet.
By signing this contract and leaving said pet with GK, the client certifies to the accuracy of all information givne about said pet on this form and therefore cannot hold GK liable for circumstances that happen due to inaccurate information on said pet.
The client understands that for the safety of the pets and others that GK requires all pets enter and leave GK on a leash or in a carrier. GK is not liable for any injury you or your pet incur while at GK

Client Signature

Clear

Date

Graced Animal Services & Kennel

Customer Information:

Pet Information:

This contract is between Graced Animal Services & Kennel (hereinafter referred to as "GK") and the pet owner whose signature is below (hereinafter referred to as "client").