Adobe FormsCentral

KEY RELEASE

I authorize Leash & Lead! and its representatives to have access to my house keys and allow them entry into my home while they are contracted to care for my pet(s). I understand that if Leash & Lead does not keep my keys there may be a $5.00 fee to return and pick them up.

*

Keep my keys on file for future visits I will pick up my keys

Pet Owner Name: *

Date: *

Date

By typing in my full name I acknowledge this will serve as my Digital Signature and be binding as such.

Signature: *

MEDICAL RELEASE

In the event any of my animals become ill, Leash & Lead is authorized to take them to either my veterinarian or selected after-hours emergency clinic to diagnose their condition. The veterinarian is to call me for authorization to treat. If I am unavailable and this is an emergency, the veterinarian is hereby authorized to treat the animal at their discretion. The charges for any vet visit or treatment will be my responsibility with the veterinarian or clinic.

I authorize him/her to charge up to $ for treatment *

Should the vet or clinic require immediate payment it may be charged to the credit card listed below.

Credit Card Type:

Name as it appears on card:

VACCINATION INFORMATION

All animals must be up to date on their rabies vaccinations before Leash & Lead will care for them. I confirm all of my animals are current on their rabies vaccinations.

My pets are current on their rabies: *

Yes No

If no, please explain:

Pet Owner Name: *

Date Signed: *

Date

By typing in my full name I acknowledge this will serve as my Digital Signature and be binding as such.

Signature: *