Cedarcrest Animal Hospital 2021 Playcare Agreement
Please fill out this form for each of your dogs that will be attending Playcare.
Client's Name
*
Mr.
Mrs.
Miss
Ms.
Prefix
First Name
Last Name
EMERGENCY Contact Number
*
-
Area Code
Phone Number
How would you like us to communicate NON- emergency information?
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TEXT
EMAIL
PHONE
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please list all people authorized to pick up your pet.
*
Pet's Name
*
Species
*
Sex
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Unknown
Age
*
Terms and Conditions:
I understand that all pets are checked for fleas and ticks upon admittance. If evidence of either is found, a Capstar will be given at my expense.
I understand that my dog, if 7 months of age or older, must be spayed or neutered prior to attending Playcare.
I understand that my dog must be current on required vaccinations/testing and I will provide Cedarcrest Animal Hospital with the vaccination history if vaccinations and/or testing were done at another veterinary hospital. I agree to provide Cedarcrest Animal Hospital with updates of my dog’s vaccination records. I acknowledge that it is my responsibility to ensure that my dog continues to be fully vaccinated and that Cedarcrest Animal Hospital reserves the right to remove my dog from the facility if it is not fully vaccinated.
I understand that Cedarcrest Animal Hospital has relied upon my presentation that my dog is in good health and has not injured or shown aggression or threatening behavior to any person or dog in admitting my dog for services at their facility.
I understand that Cedarcrest Animal Hospital owners, staff, partners, and volunteers, will not be liable, financially or otherwise, for injuries to my dog, myself, or any property of mine while my dog is participating in services provided by Cedarcrest Animal Hospital. I hereby release Cedarcrest Animal Hospital of any liability of any kind arising from my dog’s participation in any services provided by Cedarcrest Animal Hospital.
I understand and agree that any problems with my dog, behavioral, medical, or otherwise will be treated as deemed best by the staff of Cedarcrest Animal Hospital in their sole discretion, and in what they view as the best interest of the animal. I understand that I am solely responsible, financially, or otherwise, for any harm or damage caused by my dog while my dog is attending any services at Cedarcrest Animal Hospital.
I understand that there are risks and benefits associated with group socialization of dogs. I agree that the benefits outweigh the risks and that I accept the risks. I understand that while the socialization and play are closely and carefully monitored by Cedarcrest Animal Hospital to prevent injury, it is still possible that during the course of normal play my dog may receive minor nicks and scratches from roughhousing with other dogs. Any injuries to my dog will be pointed out to me by staff upon pick-up.
I understand and approve the use of any training tools that the Head Trainer and Trainer’s agents deem necessary and in the best interest of the animal. These can include “The Touch”, treadmill time, the pack walk (sometimes off Cedarcrest Animal Hospital property), basket muzzle, training collar (tone, vibration, and electric stimulus settings), and slip leads.
I understand that if in the event of a medical emergency, Cedarcrest Animal Hospital has the authorization to have a licensed veterinarian examine and treat my pet as the veterinarian deems necessary. I further agree that I am solely responsible financially for any medical treatment my pet(s) receives as a result of a medical emergency while attending services provided by Cedarcrest Animal Hospital.
I understand by allowing my dog to participate in services offered by Cedarcrest Animal Hospital, I hereby agree to allow Cedarcrest Animal Hospital to take photographs or use images of my pet in print form or otherwise for publication and/or promotion.
I understand and authorize that if my dog is not picked up on time or by a date specified in a separate agreement, that Cedarcrest Animal Hospital will take whatever action deemed necessary for the continued care of my dog. I will pay Cedarcrest Animal Hospital the cost of any such continuing care. I understand that if I do not pick up my animal and ignore attempts made by Cedarcrest Animal Hospital to contact me, Cedarcrest Animal Hospital will proceed according to the guidelines provided by Georgia Statute 4-11-9.3 Abandonment of animals by owner: procedure for handling. I also acknowledge that I will be fully responsible for all attorney’s fees and associated costs if I abandon my dog.
I understand that discounted Playcare packages are only available if they are paid for in advance and that these packages are non-refundable. Fees are due and payable at the end of each day.
This agreement and waiver is valid from the date below and grants permission for future Playcare services without the need for additional authorization each time Cedarcrest Animal Hospital cares for my dog.
I grant to Cedarcrest Animal Hospital, its representatives and employees the right to take photographs of me and/or my pet, and to copyright, use and publish the same in print and/or electronically.
• I agree that Cedarcrest Animal Hospital may use such photographs of me and/or my pet with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content.
I have read and fully understand the terms and conditions set forth above.
Client's Signature
*
Today's Date
*
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Month
/
Day
Year
Date
Submit
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