Boarding Dog Information Form

Pet's Name*

Owner's Full Name*

First NameLast Name

Email

example@example.com

Address*

Street Address

Street Address Line 2

CityCounty

Postal Code

Mobile Phone# *

Area codeNumber

Emergency Full Name

First NameLast Name

Neutered or Spayed?*

If not altered, why?*

Breed(s)*

DNA results/ Breed registration?

Age of Dog*

Feeding Pattern

Level of Obedience

Dog command words used

Is he/she crate trained?*

Placeable with another dog or other dogs in play groups?*

History of Fighting with other dogs?*

Good with People - friendly? (Children/men/elders)*

Pull on a lead when out for walks?

Fears/Dislikes?*

Mess or Urinate in the Home?*

Jump up at people?*

Bark/wine/howl?*

Does he/she have separation anxiety? *

Can your dog(s) be left alone for a little while?*

Is he/she on medications long term? Medical conditions*

Possessive or protective over food, toys, chews, collar etc.*

Can he/she be left unattented a secured fenced yard ?*

History of escaping via jumping, dig out, chew or destroy fencing?*

Additional Information

Boarding Policies & Legal/ Boarding agreement

1. Rustic Rover reserves the right to immediately change your pet’s type of
boarding or daycare if we believe it is necessary to protect the health and
well-being of your pet, other pets, or our staff, and Owner agrees to pay any
additional costs associated with the change.
2. Owner agrees to pay all costs and charges for special services requeste.

3. Client will provide updated vaccination records & or titer test results from your vet before starting boarding/daycare
or boarding.
4. Owner agrees that the pet shall not leave the kennel until all charges are paid
in full to Rustic Rover
5. Owner agrees to be solely responsible for all acts or behavior of Owner’s pet
while it is in the care of Rustic Rover.
6. Owner specifically represents that they are the lawful and valid owner of the
pet, free and clear of all liens and encumbrances.
7. Owner specifically represents that the pet has not been exposed to rabies or
distemper within 30 days prior to boarding.
8. Owner agrees that in the event the boarding charges are not paid when due
in accordance with this agreement. A pet that is unclaimed at Rustic Rover
for ten (10) days beyond its scheduled discharge date is considered
abandoned and will become the property of Rustic Rover. Every effort will be
made to contact Owner if abandonment becomes an issue. If, for any reason,
the pet is not going to be picked up on the scheduled dismissal date, Owner
shall contact Rustic Rover to decide to extend the animal's stay and will pay
the additional charges based upon the aforesaid daily rate.

9. Boarding rates (length of stay) are calulated by using day rates, regardless of check in and or out times. Example: 01/02-01/07 = 6 days ; 6 days x 18 a day would be $108. Tips are always appreciated and never included in the total due.

10. Cash are always welcomed. Checks are not accepted. If using Paypal & Venmo to pay boarding fees, 3.49% plus .49 cents per transaction shall be added.

11. 50% of boarding is due at time of drop off; remaining balance is due at time of pick up. Extended stays beyond scheduled reservation can not guaranteed. Free cancellations up to 48 hours before check in. Less than 48 hour cancellations may result in a $25 cancellation fee.

12. If the pet becomes ill or if the state of the animal's health otherwise requires attention, Rustic Rover at its sole discretion, is authorized to engage the
services of a veterinarian or arrange for other requisite attention to the
animal up to and including $500.00 or ________, whichever is greater. If a
veterinarian determines that emergency treatment, which Exceeds the
authorized amount, is needed to save the animal’s life or quality of life, and
we cannot reach you or the Emergency Contact, we may authorize the
veterinarian to perform the emergency treatment. Owner agrees to be
responsible for all veterinary costs provided to your animal.

13. It is expressly agreed by Owner and Rustic Rover that Rustic Rover’s liability
in no event exceeds the lesser of the current chattel value of a pet of the
same species or the sum of $200.00, whichever is less.
14. Owner agrees to release, indemnify, and hold harmless Rustic Rover from
any and all manner of damages, claims, loss, liabilities, costs or expenses,
including reasonable attorney’s fees and related costs, arising out of or
related to Rustic Rover’s services, except which may arise from the gross
negligence or intentional and willful misconduct of Rustic Rover, including,
without limitation,

(i) any inaccuracy in any statement made by yourself or information provided by you to Rustic Rover

(ii) your dog, including but not limited to destruction of property, dog bites, injury, and transmission of disease, and

(iii) any action by yourself which is in breach of the terms and
conditions of this agreement.

15.Owner warrants and represents that Owner’s pet is not a “show dog” or
“professional" and does not participate in dog shows or professional services. Owner further represents that Owner generates no revenue or income from the
pet’s performance. Owner does not intend, plan or anticipate that its pet will
generate revenue or income in the future.
16. This Agreement shall be governed by and construed in accordance with the
laws of the State of Tennessee. Each party consents to the exclusive
personal jurisdiction of the state and federal courts of the State of
Tennessee. Owner and Rustic Rover must negotiate and mediate in good
faith prior to either party filing a cause of action.
17. Neither Owner nor Rustic Rover shall be responsible for failure or delay in
performing its duties under this Agreement if such failure or delay is due to
tornados, thunderstorms, fire, floods, drought, riot, war or other acts of
nature.

18. Words “you” and “your” refers to the Owner. Conversely, “We” and “our”
refers to Rustic Rover. Owner and Rustic Rover may collectively be referred
to as “the parties”, and singularly as a “party”.
19. Entire Agreement. This agreement, and any addendums attached,
constitutes the entire agreement between the parties. All terms and
conditions of this agreement shall be binding on the heirs, agents and
assigns of Owner and Rustic Rover Rescue & Lodge.

20. All drop off and pick ups must be scheduled via appointment. Any appointments missed without contract via text or call will be cancelled and may result in a $25 cancellation fee. Any appointments running late must text or call 865-299-3458 as soon as possible.

21. Pick up and drop off hours are normally between

9am-5pm between October to March

8am-6pm April to September.

However, appointment outside those hours are possible for exsisting customers. Please feel free to contact us for special arrangements if needed.

Read & Agreed Signature /Date *