Bampaws Stay and Play

BamPaws – Stay and Play

Boarding Service Contract

Client & Dog Information

Owner / Guardian’s Name: / 2nd Owner / Guardian’s Name:
Work Phone: / Work Phone:
Cell Phone: / Cell Phone:
Home Phone: / Home Phone:
Address:
Email Address:
2nd Email Address:
Dog’s Name/ ID: / Dog’s Birthdate:
Breed/Age/Sex: / How did you hear about us?

Emergency Information

Client’s trip location: / Contact information for trip location:
Emergency Contact: / Phones:
Alternate Emergency Contact: / Phones:
Vet Office/ Vet’s Name: / Phone:
Vet Address:
Directions to Vet’s Office:
Current Medications: / Reason(s) for Meds:
Important Medical History Notes:

Feeding Instructions

Dog’s Regular Food: / Amount/ Times of Day: / Additional Notes:
Dog’s Regular Treats: / Other treats okay? ☐ Yes ☐ No
Treat/ Dietary Restrictions:

Health Instructions

Medicine: / Amount: / Time: / Notes:
Medicine: / Amount: / Time: / Notes:
Exercise Frequency: / Exercise Duration: / Modes of Exercise:
Additional Health Care Notes:

Behavioral Instructions

Known Behavioral Issues:
Special Instructions or Notes regarding Behavioral Issues:

Description of Services

Arrival date & time: / Departure date & time:
Number of resulting days: / Rate: / Total Due:

Liability Waiver & Policies

1. Central Bark, LLC dba BamPaws Stay and Play will endeavor to offer only sound, safe, and responsible care for my dog(s). I understand that despite the best efforts of care and kennel cleanliness, certain communicable diseases, especially, but not limited to upper respiratory illness may be unavoidable in any multiple animal facility. I am responsible for Veterinary care in the event of my pet contracting such an illness. Central Bark, LLC strives to provide theutmost supervision at all times for all pets in our care. Dogs in particular are prone to rough play and injuries can occur. In such an event,Central Bark, LLCwill use nonspecific, off brand supplies for first aid treatment. In circumstances where your dog has to be transported, the dog will be crated. However, I have been told and understand the risks inherent in boarding my dog, including but not limited to interactions with other dogs and potential exposure to disease and parasites such as but not limited to fleas. Further, I am and will remain responsible for the actions of my dog at all times and I hereby agree to indemnify and hold harmless Central Bark, LLC of any and all claims of injury, expense, costs, or damages caused by the actions of my dog while under Central Bark, LLC care. I have been told by Central Bark, LLC and understand the inherent risks of owning a dog, including but not limited to the risk of dog bites to myself or others. I recognize that Central Bark, LLC is not responsible for any unintentional errors, omissions, or incorrect assertions. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service.
2. I authorize emergency medical care to be provided by the above-named veterinarian, or an appropriate alternate to be determined by Central Bark, LLC in the event my regular veterinarian is not available or that closer care is required. I will reimburse Central Bark, LLC for any charges related to emergency care up to $______. Initial______
3. In the unfortunate event your pet should pass away while in care of Central Bark, LLC, then the body will be taken to (vet/holding facility) as listed:
until further arrangements can be made".
☐ I authorize Central Bark, LLC to administer or seek 1st aid and resuscitative care for my dog(s) as determined appropriate by Central Bark, LLC and I agree to indemnify and hold harmless Central Bark, LLC for all and any results thereof.
☐ I DO NOT authorize Central Bark, LLC to administer or seek 1st aid and resuscitative care for my dog(s) as determined appropriate by Central Bark, LLC and I agree to indemnify and hold harmless Central Bark, LLC for all and any results thereof.
☐ I DO authorize my pet / pets to be comingled.
☐ I DO NOT authorize my pet / pets to be comingled.
4. Payment Policy:
5. Cancellation Policy:

This contract is validated by the signatures below in total and as approval for future services without additional written authorization.

Owner / Guardian Date

DF110/15/17