Travel Service Animal Form

Travel Service Animal Agreement and Registration Form

Client Name:   Provider Name:

RECITALS

WHEREAS, Client requires travel-related services in connection with a service animal and desires to register the animal and obtain agreed services from Provider; and

WHEREAS, Provider represents that it has appropriate experience and capacity to arrange, advise, or assist with travel accommodations, documentation review, and handling logistics related to service animals during travel; and

WHEREAS, the parties desire to set forth their respective rights and obligations with respect to the travel of the service animal as specified in this Agreement.

SCOPE OF SERVICES

SERVICE ANIMAL INFORMATION

Animal Name:   Species:   Breed:

Age:   Weight:   Color/Markings:

Service Animal trained to perform specific tasks    Psychiatric Service Animal    Emotional Support Animal    Owner-trained

Microchip/ID Number:   Veterinarian Name:

Vet Phone:   Last Vaccination Date:

TRAVEL DETAILS

Departure Date:   Return Date:

Origin:   Destination:

Carrier / Airline:   Flight Number:   Seat Preference / Location:

Assistance Required from Provider: Booking assistance    Documentation review    On-trip coordination

DOCUMENTATION PROVIDED

Letter from medical professional    Veterinary health certificate    Vaccination records    Training certificate

PAYMENT TERMS

Late fee:   Payment due within:

TERM AND TERMINATION

Agreement Start Date:   Agreement End Date:

Either party may terminate this Agreement by providing written notice at least days prior to termination. Provider may terminate immediately for client misrepresentation of the animal's status or failure to pay undisputed fees.

CONFIDENTIALITY

Provider will maintain as confidential all personal and medical information received from Client in the course of providing services, except as required by law or to perform the services (including disclosure to carriers, veterinarians, or emergency responders). Provider shall take commercially reasonable measures to protect such information.

LIABILITY, REPRESENTATIONS AND WARRANTIES

Client represents and warrants that the service animal is trained to perform tasks or is otherwise entitled to accommodations under applicable law. Client acknowledges responsibility for the animal's behavior and for any damage or injury caused by the animal. Provider's liability for any claim arising under this Agreement is limited to direct damages up to the total fees paid by Client to Provider for the applicable services; Provider is not liable for consequential, punitive, or incidental damages.

Client acknowledges that false representation of an animal as a service animal may subject Client to penalties under applicable law.

Client certifies that the animal is a service animal and that the information provided in this form is true and accurate.    Client accepts full responsibility for animal conduct during travel.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the laws of , without regard to conflict-of-law principles. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, written or oral.

SEVERABILITY

If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect and the parties shall negotiate in good faith a valid substitute provision that most closely approximates the parties' intent.

NOTICES

ADDITIONAL TERMS

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