Hotel Pet Care Application

Hotel Pet Care Application
Dog Name
Gender
Birthday/Adoption
Weight
Breed
Color/Markings
Owner Name

First NameLast Name
E-mail Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone

Area CodePhone Number
Alternate Phone

Area CodePhone Number
(Where we can reach you during daycare hours in case of questions or emergencies)

Emergency Contact:
Full Name

First NameLast Name
Relationship
Cell Phone

Area CodePhone Number
Alternate Phone

Area CodePhone Number
Veterinary Information:
Primary Clinic
Doctor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Credit Card

This information will be held in the strictest confidence and used only with your approval to pay for products and/or services with PupStars!
Credit Card:
Expires:(mm/yyyy)
Billing Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Authorization Signature
CV2#
Hotel Name:
Concierge Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Special Instructions
Medication Instructions (names & dosage)
Other Important Information:
Does your dog have any medical conditions we should know about (allergies, hip dysplasia,etc:
Is there anything specific that we should know before we enter the hotel room?
Does your dog show aggressive behavior when someone approaches?
Dog/Dog:Dog/Person
Towards menTowards women
Other Instructions
Client Agreement and Release of Liability

I hereby release PupStars Pet Care LLC., its agents, officers, sub-contractors, employees, animal owners, customers, and potential customers of PupStars Pet Care LLC. from any and all liabilities, financial, and otherwise, for injuries to myself, my dog, or any other property of mine, which arise in any way from services and/or products provided by or as a consequence of my association with PupStars Pet Care LLC.I agree to assume all liabilities and responsibilities, financial and otherwise, for the behavior and health of my dog. In consideration of the services rendered by PupStars Pet Care LLC., I waive any and all claims, actions, or demands of any nature, foreseen or unforeseen, that I may have against PupStars Pet Care LLC, Inc. relating to the care, control, health, and/or safety of my dog arising during walking time.authorize PupStars Pet Care LLC. to do whatever they deem necessary for the safety, health, and well-being of my dog while under the care of PupStars Pet Care LLC., including seeking professional veterinary treatment for my dog. I understand that PupStars PetCare LLC. has the right to refuse service to me and/or my dog at any time for any reason. I understand that if my dog has a history of or repeatedly demonstrates aggression or biting of humans or animals, PupStars Pet Care LLC reserves the right to refuse service. I understand that all bites will be reported to the local authorities as required by law.
Payment Requirements

I authorize PupStars Pet Care LLC to charge my credit card for any outstanding balance on my account. I understand that I will be charged a $30 handling fee for returned checks. By signing below, I acknowledge that I have read this Liability Agreement in its entirety and agree to the terms.
Signature
Date
Should be Empty:

Hotel Pet Care Application

(Where we can reach you during daycare hours in case of questions or emergencies)

Veterinary Information:

Credit Card

Special Instructions

Other Important Information:

Client Agreement and Release of Liability

Payment Requirements