Boarding Release Form

Please read over this yearly boarding agreement


Name *
Spouse (Other) Name
Spouse (Other) Name
Address *
Home Phone *
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Spouse (Other) Phone
Spouse (Other) Phone
Preferred Method of Contact *
Choose One
Pet Information
List ONE pet please. For additional pets, fill out this form again.
Date of Birth *
Date of Birth
If you do not know your pet's birthday, you can give your closest guess.
For unknown CAT breeds write: Domestic Short Hair, Domestic Medium Hair, or Domestic Long Hair.
Please indicate how many cups/cans you feed in the morning and in the evening. If you only feed once a day, let us know what time of day.
If your pet needs to have medications while here, please give us names of medications and directions below.
Please let us know if your pet has any behavior or medical problems that we need to watch for while they are visiting us.
V.I.P. Upgrades *
Please let us know if you would like any of the following. (You will be able to choose quantities of each upgrade when you check in.)
**Why do we need to examine your pet while here?
My dog will be walked without other pets in a fenced-in yard during scheduled walk times. *
Family households will go out together unless otherwise stated.
By signing this once a year agreement, I understand that my pet is required to be current on vaccinations (Rabies, DA2PPV/FVRCP, Bordetella, Bivalent Flu) that are necessary for boarding and free of parasites (fleas, ticks, worms) for their protection as well as the protection of the pets in this facility. Treatment will be at my expense. *
An intestinal parasite exam will be done on my pet should they display diarrhea issues. This is necessary to protect all boarders and patients. Treatment will be at my expense. *
I understand that I will be checking the information I have provided at each check-in for my pet's stay and will initial the form at each visit. If there are any changes necessary, I will inform the staff member upon check-in. *
I verify that I understand the above information, and will discuss any updates throughout the year as indicated. *
I will be asked to sign a copy of this form at the initial check in.