Dog Kennel Liability Form & Intake Questionnaire.
Provide your contact details, confirm vaccinations, authorize photo use, and acknowledge responsibilities for damages and late pickup.
Owner Full Name
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First Name
Last Name
Owner Email Address
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example@example.com
Owner’s Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Start date of stay
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Month
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Day
Year
End date of stay
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Month
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Day
Year
Rows
Name
Sex
Weight
Age
Breed
Spayed/Neutered
Dog #1
Dog #2
Dog #3
Dog #4
Vaccination Confirmation
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Rabies
Distemper
Bordetella
My pet is currently recieving flea and tick prevention
Please upload verification of your dogs vaccination information here:
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Veterinarian Name
Veterinarian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Veterinarian Clinic Name
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Please list any health issues/ medications/ allergies/ or need to know information below:
Feeding instructions: (brand, amount, frequency, restrictions)
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Emergency contact name:
*
Emergency contact phone number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Liability Agreement
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By checking this box, I agree to the below liability agreement. 1. ASSUMPTION OF RISK Owner acknowledges that boarding, daycare, salon, and group play involve inherent risks, including but not limited to illness, injury, escape, stress, altercations with other animals, and exposure to communicable conditions. Owner voluntarily assumes all such risks associated with leaving their pet(s) in the care of Piney Paws Kennels. 2. VACCINATION & HEALTH REQUIREMENTS Owner certifies that each pet is current on all required vaccinations: for dogs — Rabies, DHPP, and Bordetella. Pets must be on flea, tick, and parasite prevention. Owner represents that the pet is in good health, free of contagious illness, and has not been exposed to any communicable disease within the past 30 days. Proof of vaccination must be provided prior to check-in. 3. BEHAVIOR & TEMPERAMENT DISCLOSURE Owner agrees to fully and truthfully disclose any history of biting, aggression, food or resource guarding, severe separation anxiety, or other behavioral concerns. Piney Paws Kennels reserves the right to refuse service or remove a pet from group settings at any time for the safety of staff and other animals. Owner is responsible for any injuries or damage caused by their pet. 4. EMERGENCY VETERINARY CARE In the event of illness or injury, Owner authorizes Piney Paws Kennels to seek veterinary care at the nearest available veterinarian or the pet's regular vet, up to a limit of without further $500 authorization. Owner is fully financially responsible for all veterinary costs, transportation, and related expenses, regardless of outcome. 5. MEDICATION & FEEDING Owner must provide all medications in original containers with clear written instructions and is encouraged to provide the pet's regular food to avoid digestive upset. Piney Paws Kennels will make reasonable efforts to administer medication and follow feeding instructions but is not liable for adverse reactions, missed doses, or refusal to eat. 6. PERSONAL BELONGINGS Piney Paws Kennels is not responsible for loss of or damage to personal items left with the pet, including beds, blankets, toys, leashes, collars, or bowls. Owner is encouraged to label all items but acknowledges items may be lost, soiled, or destroyed during the stay. 7. PHOTO & VIDEO RELEASE Owner grants Piney Paws Kennels name permission to photograph and video record the pet for use in marketing, social media, and promotional materials. 8. CANCELLATION & NO-SHOW POLICY Cancellations must be made at least 7 days in advance of the scheduled check-in date. The deposit of $50 is non-refundable for late cancellations or no-shows. Holiday and peak-season reservations may be subject to stricter cancellation terms communicated at the time of booking. 9. LATE PICK-UP & ABANDONMENT Owner agrees to pick up the pet by the scheduled check-out date and time. Late pick-ups will incur additional daily boarding fee of $40 based on a percentage of the standard rate of per stay. Pets not picked up within 7 days after the scheduled check-out, with no communication from Owner, will be considered abandoned and may be surrendered to a shelter or rehomed. Owner remains liable for all accrued fees. 10. LIABILITY RELEASE Owner, on behalf of themselves, their heirs, and assigns, hereby releases Piney Paws Kennels, its owners, employees, contractors, and agents from any and all claims, demands, damages, or causes of action arising from the boarding, daycare, transport, grooming, or handling of the pet, except in cases of gross negligence or willful misconduct. 11. AGREEMENT By signing below, Owner acknowledges they have read, understood, and agree to the terms of this Waiver and Release, certify all information provided about the pet is accurate, and accept all risks associated with leaving the pet in the care of Piney Paws Kennels.
Photo Release Consent
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I give permission for my dog's photos to be used for promotional purposes.
I do NOT give permission for my dog's photos to be used.
Signature
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Date
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Month
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Day
Year
Date
Submit
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