Fill and Sign the Agreement Form Animal

1 Copyright 2004 USLegalforms.com PET CARE AGREEMENT The purpose of this Authorization and Agreement is to provide temporary care for a pet, confirm that the pet will be returned to the OWNER, and limit liability. As used in this Agreement: “OWNER” shall refer to whose address is City/State/Zip . “Pet” shall refer to a , named whose breed is, age years, and whose gender is male female. “CAREGIVER” shall refer to whose address is City/State/Zip . 1. OWNER agrees to place Pet in the temporary care of CAREGIVER whom OWNER reasonabl y deems suitable to care for Pet as described herein, and who shall supply OWNER with the name, address and telephone number of CAREGIVER 2. CAREGIVER agrees to care for Pet as provided herein until it is returned to OWNER, reply to OWNER’S inquiries about Pet, notify OWNER of changes of address and telephone number of CAREGIVER, and return Pet to OWNER upon request. As used in this Authorization and Agreement, “Care” shall include providing Pet with food, water and shelter, giving reasonable attent ion to Pet’s health, safety and grooming, and attending to the following special instructions: Otherwise, CAREGIVER will have no liability to OWNER except that which might arise irrespective of this Authorization and Agreement. 3. OWNER authorizes CAREGIVER to seek appropriate veterinary medical treatment or a ttention on behalf of Pet as may be reasonably required by the circumstances, including but not lim ited to examination, preventative and/or curative treatment, x-ray, laboratory examination, anesthetic, vete rinary medicine diagnosis, and consultations (“Veterinary Services”). Pet shall not be subjected to research or experimentation. 4. OWNER authorizes CAREGIVER to make reasonable decisions regarding Care and veterinary services, and consents to CAREGIVER’S reasonable decisions, acts and omissions, including the risks thereof. 5. OWNER authorizes the euthanasia of Pet if it becomes gravely injured or ill, and a veterinarian recommends either euthanasia or treatment costing in excess of $ but not before contacting OWNER (if left blank, then the amount shall be $1,000.00). 6. OWNER agrees to reimburse CAREGIVER for veterinary services, payment to be made in full within 12 months from the date that Veterinary Services are rendered. OWNER also agrees to pa y the cost of transporting Pet from CAREGIVER to OWNER. Otherwise, OWNER shall have no financial obligati on to CAREGIVER hereunder unless OWNER specifically agrees otherwise in a writing signed by OWNER. 7. OWNER shall remain the OWNER of Pet, and be entitled to sole custody and possession of Pet at such time as OWNER desires. However, OWNER shall not be entitled to interfere in providi ng care to Pet while in the custody of CAREGIVER if the interference is contrary to the explicit terms of this Contract. 2 Copyright 2004 USLegalforms.com 8. CAREGIVER agrees that OWNER shall not be liable if Pet causes CAREGIVER to sustain injuries or losses, unless caused by a dangerous propensity of Pet (unknown to CAREGIVER). 9. CAREGIVER agrees that under no circumstances will the aforementioned Pet be sold, tra nsferred, leased, donated or relinquished to any institution, pet store, shelter, individual or other ent ity except as explicitly authorized by OWNER. 10. OWNER represents that Pet has no known diseases that can be transmitted to animal s or humans, that no court or animal control proceeding has adjudged Pet to be “dangerous” or “vicious,” that Pet has never attacked and injured a human being, and that Pet has never been a combatant in illegal pet fighting. If any of these representations are untrue, then CAREGIVER shall have the right to terminate this Agreement and Authorization. Upon being so notified, OWNER shall have the duty to take possession of Pet within 30 days. If OWNER fails to do so within that time, then CAREGIVER shall have the right to deliver Pet to an animal shelter for disposition at its discretion. 10. This Authorization and Agreement may be executed prior to knowing who CAREGIVER may be. Therefore, execution by CAREGIVER is not required until such time as CAREGIVER takes custody of Pet. In that event, CAREGIVER shall mail OWNER a fully signed copy hereof. 11. Additional requirements as agreed upon by OWNER and CAREGIVER: This Authorization and Agreement replaces all prior authorizations and agreements. The terms hereof are not set by law and are fully negotiable until it is signed. If any provision hereof is i llegal or unenforceable, it will not invalidate or make unenforceable the entire Authorization and Agreeme nt, but only the particular provision that is illegal or unenforceable, and the remainder of the Authorization and Agree ment shall be enforced as if that particular provision had never been included herein. Dated: OWNER CAREGIVER