Dog Country LLC - Release of Information and Liability Agreement

Dog Country LLC - Release of Information and Liability Agreement
Owner Information

First NameLast Name
Pet Information

Dog(s) NameDog(s) Name
I understand that I am solely financially responsible for any injury my dog(s) and/or damages to Dog Country property caused by my dog(s) during their stay at this facility [WI STAT.SECT. 174.02].
Please Initial
I also understand that Dog Country and their staff will not be liable for any injury that may happen to my dog(s), provided reasonable care and precautions are followed. I hereby release Dog Country of any and all liability that may arise during their activities on this property.
Please Initial
I further understand and agree that the staff of Dog Country will use their best judgement to treat any problems, such as damage to property, which may arise and I will assume full financial responsibility for any expenses incurred.
Please Initial
I grant permission to the staff of Dog Country to request, receive or verify health and medical information regarding my dog(s) ______ with the staff of my veterinary clinic, if necessary, (a copy of this release may be filed with your veterinary clinic).
Dog(s) Name
I certify that I have read and understand the above rules and regulations of Dog Country and agree to abide by the terms of this agreement.
Please Initial
When boarding my dog(s) at Dog Country, I fully understand that there is a risk of injury if my dog(s) interact with other dogs while boarding.
Please Initial
I do do not give consent for my dog(s) to interact with other dogs while boarding at Dog Country and accept any and all financial responsibility for damages or necessary treatment for my dog(s).
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Staff Signature (Leave Blank)
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: