BOARDING REGISTRATION & PROFILE

Today's Date

Date

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

File Upload

Home Number

Please enter a valid phone number.Format: (000) 000-0000.

Work Number

Please enter a valid phone number.Format: (000) 000-0000.

Cell Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Second Responsible Party Name

First NameLast Name

Second Responsible Party Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Second Responsible Party Home Number

Please enter a valid phone number.Format: (000) 000-0000.

Second Responsible Party Work Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Second Responsible Party Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Second Responsible Party Email

example@example.com

Authorized Emergency Contact

First NameLast Name

Emergency Contact Home Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Work Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Email

example@example.com

Other people authorized to pick up pet.

Account Password - Please designate a password that will only be known by Bed Bath & Biscuits and those persons you deem authorized topick up your dog(s). Please be advised that your dog(s) will not be released by Bed Bath & Biscuits or any of its representatives to any unknown or authorized persons without knowledge of this password (MUST BE BETWEEN 6-12CHARACTERS IN LENGTH)

How did you hear about us?

Date of Pet Arrival

Date

Date Pet Leaving

Date

Pet Name

Breed / Color

Sex

Spay / Neutered?

Weight

Age

Birthday

Microchip

Vet Clinic

Doctor

Vet Address

Vet Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Medical Conditions or Allergies

Medications & Schedule

Food & Dietary Instructions

How does dog get along with other animals in house?

Has dog been to a dog park?

Has dog been to Day Care?

Has dog ever been boarded?

Was boarding a positive experience?

Does dog have any sensitve spots?

Does dog have favorite petting spots?

Has dog ever bitten or been bitten? Provide details.

Does your dog have a problem in any of the following areas: chewing/mouthiness; house training; barking; digging; jumping; eating foreign objects; escaping, lightning, thunderstorms, etc… Provide details.

What commands does your dog know?

What toys and games does he like to play?

Has dog had formal obedience training?

If yes, when & where was obedience training?

Initials - I certify my dog(s) meets all of the above requirements.

Initials - I certify I am the legal owner of the dog(s) on this application.

Initials - I certify that, to my knowledge, my dog(s) has not been exposed to Kennel Cough, Distemper, Rabies or Parvovirus within the past 30 days.

Initials - I certify my dog is free from intestinal parasites.

Initials - I certify my dog(s) has been vaccinated as required by Bed Bath & Biscuits.

Pet Parent Name

Pet Parent Signature

Dogs Name - For Pet Parent Signature Section

Date

Initials - Client & Release of Liability Agreement: I hereby hold harmless and indemnify Bed Bath & Biscuits , its agents, officers, sub-contractors, employees, pet owners, customers, and potential customers (Indemnified Parties) from any and all liabilities, financial or otherwise, for injuries to myself, my pet(s), or any other property of mine which may arise from services that are rendered by Bed Bath & Biscuits or as a consequence of my association with Bed Bath & Biscuits except to the extent caused by gross negligence, bad faith, or intentional misconduct of the Indemnified Parties.

Initials - Client & Release of Liability Agreement: In consideration of the services rendered by Bed Bath & Biscuits, I agree to assume any all liability financial or otherwise, for the behavior and health of my pet arising in connection with such services. I waive any and all claims, actions, or demands of any nature, either foreseen or unforeseen, that I may have against Bed Bath & Biscuits relating to the care, control, health, and safety of my pet arising in connection with the services that are rendered by Bed Bath & Biscuits except to the extent caused by gross negligence, bad faith, or intentional misconduct of the Indemnified Parties.

Initials - Client & Release of Liability Agreement: I hereby authorize Bed Bath & Biscuits, its agents, officers, sub-contractors, and employees to do whatever they deem necessary for the safety, health, and well-being of my pet while under the care of Bed Bath & Biscuits.

Initials 4 - Client & Release of Liability Agreement: By signing below, I acknowledge that I have read this agreement and release of liability in its entirety and agree to the terms. This agreement shall be binding for every time services are rendered by Bed Bath & Biscuits on my behalf.

Signature - CLIENT AND RELEASE OF LIABILITY AGREEMENT

Date - CLIENT AND RELEASE OF LIABILITY AGREEMENT

Date

Dog Name - CLIENT AND RELEASE OF LIABILITY AGREEMENT