Fill and Sign the Boarding Agreement Form

Boarding Contract or Contract with Dog Kennel Agreement made on the _____________ (date) , between ___________________ (Name of Pet Owner) of ________________________________________________________ __________________ (street address, city, county, state, zip code) , referred to herein as ___________________ (Pet Owner) , and __________________________ (Name of Kennel) , of __________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as Kennel . For and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Information About Dog or Pet A. Name of Dog or Pet ______________________________________________ B. Name of Veterinarian ____________________________________________ Phone Number ___________________ C. Grooming Information 1. Name of Groomer: _____________________________________ 2. Groomer’s Phone Number _______________________________ 3. How often Dog or Pet is groomed and/or bathed at home: __________ D. Breed of Dog _________________________________________________ E. Sex _______ F. Age ________ G. Color/Markings _________________ H. License No. ____________________________ I. Has the Dog bitten anyone? ___________ If so, what were the circumstances? ______________________________________________________________ ______________________________________________________________ J. Does your Dog have a tendency to do any of the following: 1. Jump __________ 2. Climb ________ 3. Run Away __________ 4. Dig ___________ K. Unusual Tendencies 1. Fear of ___________________________________________________ 2. Dislike of __________________________________________________ 3. Adverse reaction to strangers _________________ 4. Urinate when approached ____________ 5. Engages in self-mutilation _____________ 6. Behavioral problems: _______________________ L. Training 1. What training has Dog had ____________________________________ 2. Does he/she respond to commands when called ________________ 3. Is he/she housetrained ________ 4. Who administers correction/discipline ____________ 5. What type of correction/discipline has proven effective ____________ _________________________________________________________ 6. In stressful situations, does Dog react: [ ] wildly active [ ] active [ ] poised [ ] assured [ ] reserved [ ] withdrawn (lethargic/stiff) M. Are there any legal actions or complaints filed, pending, or in force with respect to your Dog’s behavior of said Dog? __________ N. Has Dog been boarded before: _______________________ O. Any signs of separation anxiety or stress when boarded___________________ P. Medications 1. Name and dosage __________________________________________ 2. When does medication need to be administered __________________ Q. Type/Brand of food: __________________ R. Medical problems 1. Skin trouble _____________ 2. Arthritis ____________ 3. Other ______________ 4. Have you pre-authorized your veterinarian to treat your Dog in case of illness while you are gone ____________ 2. Information about Pet Owner A. Home Address: ________________________________________________ _________________________________________________ B. Phone Numbers 1. Home Number _______________________________ 2. Work Number ________________________________ 3. Cell Phone Number ________________________________ 4. Emergency Phone Number ___________________________ 3. Length of Time to be Boarded A. Number of days ________. Owner hereby agrees to pay the rate of $______ per day. Owner ’s initials _____________ B. Number of weeks ________. Owner hereby agrees to pay the rate of $______ per week. Owner ’s initials _____________ C. Number of months ________. Owner hereby agrees to pay the rate of $______ per month. Owner ’s initials _____________ D. Owner understands and agrees that the above rates will be doubled, on a per day basis, for each extra day the Dog is boarded, if the Dog is not retrieved by the Owner by the agreed upon boarding time period stated herein. Owner ’s initials _____________ 4. Kennel agrees to exercise due and reasonable care to board the Dog for the Owner . Kennel does not assume and shall not be held responsible for any liability with respect to the Dog listed in this agreement, of any kind, character, or nature whatsoever, arising out of or from the boarding of this Dog, or any damages which may accrue from any other cause whatsoever, including loss by fire, theft, running away, injury to persons, animals or property, unavoidable causes, or death or injury to any other animal caused by the within named Dog during the term of this contract, whether this Dog be on the premises of the Kennel or not. Owner hereby agrees to be and is solely responsible for any and all acts of behavior of said Dog at any time within the term and time for the contract. In no case shall the Kennel be in any way liable or responsible. 5. Under no circumstances shall the Kennel be liable to the Owner or any third party in an amount exceeding the sum of One Hundred Dollars ($100.00). Owner agrees not to claim any damages against said Kennel of any nature whatsoever, either by way of contract, equity, negligence or otherwise, in excess of said sum. 6. Owner specifically covenants, warrants and represents the following: A. He/she is the sole owner of said animal; B. There is not now any lien or mortgage against said animal; and C. The animal has not been exposed to distemper or rabies within the last thirty days, and that the required annual license has been obtained. 7. Kennel shall have, and Owner hereby grants to Kennel , a lien on the aforesaid animal for any and all unpaid boarding and/or other charges resulting from the boarding of said animal within the Kennel . The Owner hereby agrees that in the event the monthly or weekly boarding charges are not paid within thirty days after they become due an payable in accordance with the terms of this contract, the Kennel may exercise its lien rights, and ten days after notice to Owner may dispose of said animal for any and all unpaid charges, at private or public sale, and Owner specifically waives and claims if such sale does not secure a price adequate to pay such costs of board and/or other charges delinquent plus costs of sale, then Owner shall and must pay to Kennel the difference. Any monies realized by the Kennel at such a sale, over and above the charges due and cost of sale shall be returned to the Owner . Notice shall be conclusively deemed to have been given pursuant to this paragraph if notice in writing of such intended sale shall be mailed by registered mail to the Owner of the within named animal at the address given herein, and no further notice shall be required. 8. If the animal becomes ill, or Kennel suspects animal is ill, the Owner shall be notified at once, collect, if possible, or such attempt shall be made to so notify the Owner , and if Owner does not immediately inform the Kennel regarding measures to be taken or if the state of the Dog’s health requires quick action, the right to all a veterinarian or to administer medicine or to give advisable attention within the discretion of the Kennel , and such expenses being reasonable in amount shall e promptly paid by Owner . If Dog is to be groomed, it shall be groomed by: ______________________, and the Owner hereby deposits with the Kennel $ ______________ for same. Dog shall be groomed ________________________________. 9. Unless Owner files with Kennel , within thirty days from the date the animal is removed from Kennel , a written demand for any claimed injury or damages resulting from the boarding of said Dog under this contract, said Owner shall and does hereby waive any and all rights which he may have against the Kennel for any liability arising under this contract, for damages, or otherwise. 10. The animal may to be taken off premises by the Kennel without the consent of the Owner . 11. Owner personally guarantees full payment of the boarding fees. Interest charged on an overdue bill shall be at the maximum rate allowed by law, but not to exceed 1.5% per month, compounded daily. 12. Owner hereby attaches proof of current rabies immunization, distemper, hepatitis, leptospirosis and canine cough vaccinations as required by law. 13. Severability The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. 14. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 15. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________. 16. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 17. Attorney’s Fees In the event that any lawsuit is filed in relation to this Agreement, the unsuccessful party in the action shall pay to the successful party, in addition to all the sums that either party may be called on to pay, a reasonable sum for the successful party's attorney fees. 18. Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 19. Entire Agreement This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 20. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 21. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. 22. In this contract, any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. WITNESS our signatures as of the day and date first above stated. ___________________________ (Name of Kennel) ________________________ By:_________________________ (P rinted name) (P rinted name) ________________________ _________________________ (Signature of Pet Owner) (Signature) Medical Treatment Authorization To Whom It May Concern: 1. Kennel is the present pet care provider for my Dog. I hereby authorize and voluntarily consent to having Kennel arrange, direct, sign for and consent to any and all routine or emergency medical care and treatment necessary to preserve the health of my Dog. Information is set forth below. 2. ____________________ (Name of Pet Owner) acknowledges that he is responsible for all reasonable charges in connection with the care and treatment rendered and acknowledges that no guarantees have been made as to the effect of such treatment rendered. Pet Information Name: _____________________________________________________________ Date of Birth: _________________________ Sex: __________________ Color of Eyes: ________________ Color of Hair and Identifying Marks: _________________________________________ Medical Conditions: ________________________________________________________ ________________________________________________________ Witness our signatures this ________________ (date) . _______________________ (Name of Kennel) ________________________ By: _________________________ (P rinted name) (P rinted name) ________________________ _________________________ (Signature of Pet Owner) (Signature)