Dog House Boarding and Grooming LLC.

Owner responsible to notify Dog House Boarding and Grooming of any changes to the information supplied on this form. prior to dropping off dog for grooming/boarding.

Format: (000) 000-0000.

malefemalespayed/neutered

Yes - GroomingYes - WalkingNoOther

UnderweightIdeal WeightOverweight

Format: (000) 000-0000.

Address

Street Address Line 2

City

RabiesDHPPBordatellaOther

Format: (000) 000-0000.

By checking here. you agree to be solely responsible for the payment of all medical bills for your dog and you release Erica Bellini, agents, family members and employees of and from any and all responsibility for, or claims, damages, debts, arising out of or related to such medical care. including but not limited to, transportation to/from the veterinary clinic and choice of veterinarian and animal hospital. Pickup of your dog We will release your dog to the following person(s)

By checking here. you may verbally (by telephone) or in writing (facsimile or otherwise) request that we release your dog to someone other than the person(s) listed above. and you release us of and from any and all responsibility for releasing your dog to any person we reasonably believe to be authorized by yourself.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Dog House Boarding and Grooming reserves the right to immediately change your dog’s type of boarding/daycare or grooming services if we believe it is necessary to protect the health and well-being of your dog, other dogs, or our staff.

All dogs must be healthy, and current on all vaccinations. You may be required to bring a copy of your dog’s updated vaccination records from your vet before you start daycare or board with us to ensure your dog’s safety as well as that of other dogs on the premises.

If your dog is exhibiting any symptoms that may suggest illness such as sneezing, coughing, wheezing, runny eyes or nose, vomiting, lethargy, or diarrhea, please do not bring your dog for boarding. Dogs with flea or tick problems will be bathed at the owner’s expense.

A boarding period is the unit of time that starts on the day of drop-off and ends at noon of every subsequent day, meaning the first day is always charged. The last day will not be charged when your dog is picked up by 10 a.m. EST. The last day will be charged when your dog is picked up after 10 a.m.

Payment is due upon pickup of your dog (cash only). We reserve the right to adjust fees for services.

Cancellations must be made 48 hours prior to the appointment or service. Failure to do so may result in a cancellation fee or refusal of future service.

By submitting this form and checking below,

You indicate your agreement with all the terms listed hereof,

You authorize Erica Bellini to obtain medical and vaccination records for your dog from the veterinarian listed above and youhereby authorize your veterinarian to provide these records to Erica Bellini.

You release, indemnify, and agree to hold Erica Bellini, agents, family members and employees harmless from any and allmanner of damages, claims, loss, liabilities, costs or expenses, causes of actions or suits, whatsoever in law or equity, (including,without limitation, attorney’s fees and related costs) arising out of or related to the services provided.

This agreement covers the current relationship between Erica Bellini and yourself. Each time you bring your dog for boarding, grooming, or other services, you affirm the terms of this Agreement, and the truthfulness and accuracy of all statements you make in this Agreement.

Dog House Boarding and Grooming LLC.

Boarding Agreement

About Your Pet

Medical Emergency Information

Emergency Contact

Emergency Medical Care

Dog House Boarding and Grooming LLC Policies