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  • ANIMAL INTAKE

    ANIMAL INTAKE

    for trailer pickup and shelter use
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  • ANIMAL OWNER OR KEEPER INFORMATION

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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • ANIMAL INFORMATION

  • Choose animal type
  • Gender
  • Spayed/Neutered
  • LIABILITY WAIVER & ACKNOWLEDGMENT

    By signing below, I ("Owner") acknowledge and agree to the following terms and conditions as a legally binding agreement with the Horse Emergency Evacuation Team, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated regarding the sheltering of my animal. 1. Acknowledgment of Risk I understand and acknowledge that sheltering an animal involves inherent risks, including but not limited to exposure to other animals, potential injury, illness, stress-related behavior, or escape, despite Facility's reasonable efforts to provide a safe and sanitary environment. I voluntarily assume all risks associated with sheltering my animal with Horse Emergency Evacuation Team, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated. 2. Release of Liability & Hold Harmless To the fullest extent permitted by California law, I hereby waive, release, and discharge Horse Emergency Evacuation Team,, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated, their agents, employees, contractors, successors, volunteers, and assigns from any and all claims, liabilities, damages, or causes of action arising out of or related to injury, illness, death, escape, loss, or theft of my animal while in the care, custody, or control of Horse Emergency Evacuation Team, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated including during emergency care or transport. I further agree to indemnify, defend, and hold harmless Horse Emergency Evacuation Team, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated from any claims made by third parties that arise out of my or my animal's conduct while on Temporary Shelter premises.

    3. Medical Treatment Authorization

    If my animal becomes ill or injured while boarding and I cannot be reached in a timely manner, I authorize Horse Emergency Evacuation Team or Counties of San Luis Obispo Division of Animal Services ("Animal Services") or Santa Barbara Animal Services or Elks Recreation Incorporated to seek veterinary care, including emergency treatment, at its discretion. I agree to be solely financially responsible for any such veterinary expenses incurred. 4. Agreement to Retrieve Animal I agree to retrieve my animal upon the release of evacuation warnings or orders affecting my place of residence. If I fail to retrieve my animal within 72 hours of that time, and have not communicated with Horse Emergency Evacuation Team, Counties of San Luis Obispo Division of Animal Services ("Animal Services") or Santa Barbara Animal Services or Elks Recreation Incorporated to make alternative arrangements, I understand and agree that Horse Emergency Evacuation Tea, Counties of San Luis Obispo Division of Animal Services ("Animal Services") and Santa Barbara Animal Services and Elks Recreation Incorporated may consider the animal abandoned and may re-home or otherwise place the animal in accordance with California Civil Code $1834.5 and/or $1834.6, and local ordinances.

    5. Behavior & Health Disclosure

    I affirm that I have disclosed all known health issues, special needs, and behavioral concerns (e.g., aggression, fear, reactivity) related to my animal. I understand that failure to disclose such information may increase risks to my animal or others and may result in additional charges, early termination of services, or refusal of future boarding. 6. Property Damage I understand and agree that I am responsible for any property damage caused by my animal to Horse Emergency Evacuation Team or to third parties (sheltering property) during its stay. 7. Governing Law & Severability This agreement shall be governed by the laws of the State of California. If any portion of this agreement is deemed unenforceable, the remainder shall remain in full force and effect.

    Acknowledgment & Signature at Pick Up I have read and understood this Hold Harmless Acknowledgment & Boarding Agreement. I voluntarily agree to all of its terms.

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  • STOP ENTERING INFORMATION HERE, THE REST OF THE FORM IS FOR RETURNING YOUR ANIMAL TO YOU------YOU DO HOWEVER NEED TO SCROLL TO THE BOTTOM OF THE FORM AND CLICK ON SUBMIT   ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

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  • Format: (000) 000-0000.
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