Elliotte’s Pet Spa & Salon Inc.

Owner's Name:

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:

Please enter a valid phone number.

Email:

example@example.com

Pet's Name:

Breed:

Age:

Sex:

Coat Color/Length:

Vet:

Rabies:

Health Conditions:

IntactSpay/Neuter

Referred By:

Customer Agreement and Release of Liability

We ask that you to sign a Customer Agreement and Release of Liability form with your first visit. The agreement, shown below, also includes vaccination requirements and cancellation policies.

□ Customer releases Elliotte’s Pet Spa & Salon Inc. and its agents from any and all liabilities, financial, and otherwise, for injuries to Customer, Customer’s pet, or any other property of Customer, which arise in any way from services and/or products provided by or as a consequence of Customer’s association with Elliotte’s Pet Spa & Salon Inc. including, but not limited to, veterinarian bills.

□ Customer assumes all liabilities, financial and otherwise, for the behavior and health of their pets. In consideration of the services rendered by Elliotte’s Pet Spa & Salon Inc., Customer waives any and all claims, actions, or demands of any nature, foreseen or unforeseen, against Elliotte’s Pet Spa & Salon Inc. relating to the care, control, health, and/or safety of Customer’s pet arising during services performed by Elliotte’s Pet Spa & Salon Inc

□ Customer understands that Elliotte’s Pet Spa & Salon Inc has the right to refuse service to Customer’s pet at any time for any reason. Customer understands that if their pet has a history of or repeatedly demonstrates aggression or biting of humans or animals, Elliotte’s Pet Spa & Salon Inc reserves the right to refuse service. Customer also understands that all bites will be reported to the local authorities as required by law.

□ Customer must be the legal owner of the pet.

□ At time of grooming appointment, Customer must present records demonstrating the pet’s rabies vaccination is up to date. The pet must not have been exposed to distemper, rabies, or parvovirus within the past 30 days.

□ A minimum of 24 hours’ notice is required for the cancellation of grooming appointment. If the appointment is not cancelled prior to 24 hours, Customer will be charged a fee of $25.00 for a no show/no call cancellation.

Signature

Date