5177 Watkins Road SW

Pataskala, OH 43062

740-927-7829 (STAY)

MEEGAN KENNELS

Boarding, Day Boarding and Grooming Application/Agreement

Owner Information:

Name:
Street:
City: / State: / ZIP Code
Home Phone: Cell: / Cell Phone: / Work Phone:
Email:
How did you hear about us? Location Newspaper Vet Website Google Referral Other / Web Site Google Word of Mouth / Other

Emergency Contact and Authorized Alternative Pickup:

Emergency Contact Name: Phone Number: Authorized Pick up Yes No / Phone: / May Pick Up Yes No
Pet #1 Information:
Name: Dog Cat
Breed: Color / Weight
/ Weight
Sex: Male Female Spayed/Neutered Yes No Date of Birth / Neutered/Spayed? Yes No / Birth Date:

Pet #2 Information:

Name: Dog Cat
Breed: Color Weight / Weight
Sex: Male Female Spayed/Neutered Yes No Date of Birth / Neutered/Spayed? Yes No / Birth Date:

Pet #3 Information:

Name: Dog Cat
Breed: Color / Weight
Sex: Male Female Spayed/Neutered Yes No Date of Birth / Neutered/Spayed? Yes No / Birth Date:

Medical Information:

Veterinary Clinic Phone / Vet’s Name: / Phone:
Describe any medical information, conditions, allergies:
Vaccination Release: I have contacted my vet and given permission to release vaccination information.

History & Environment:

How long have you had your pet?
Has your pet ever bitten a person?
Has your pet ever bitten another animal?
Has your pet ever been attacked by another animal?
Did you purchase or adopt your pet?
Does your pet have separation or storm anxiety?
Does your dog climb, dig under or jump fences?
Does your dog have any formal training?
Does your pet have any fears or dislikes?
Is your dog housebroken?
Is your dog allowed to have Milkbone treats?
Is your cat allowed to have cat treats?
Does your pet attend other boarding, daycare or grooming facilities / If yes, where

Agreement:

This agreement is between pet owner and Klondike Kennels, LLC, doing business as Meegan Kennels. All references to Meegan Kennels are on behalf of Klondike Kennels, LLC.

Pet owner certifies that their pet is in good health and has not injured or shown aggression or threatening behavior to any person or other animal.Meegan Kennels reserves the right to refuse services to any pets showing aggressive or threatening behavior.

Pet owner agrees that Meegan Kennels has the right to decline reservation requests if their pet is not current on all required vaccinations.

Meegan Kennels agrees to exercise due diligence and care in the guardianship of the pet, and to keep the facility properly enclosed and sanitary.

Pet Owner agrees that any problems with their pet, behavioral, medical or otherwise will be treated as deemed best by staff or agents of Meegan Kennels in their sole discretion, and in what they view as the best interest of the animal. If the pet should become in need of veterinary care, the pet owner grants Meegan Kennels, its owners, employees or agents permission to transport their pet to a veterinarian for treatment and agree to pay all costs associated with said treatment. Pet Owner assumes full financial responsibility and all liability for any and all expenses involved in regards to the behavior and health of their pet.

The owner further agrees to be solely responsible for any and all acts or behavior of this pet while it is in the care of Meegan Kennels, to include payment of costs for injury to staff or other animals or damage to facilities caused by the pet.

Pet Owner hereby releases and agrees to hold harmless Deb Gutman, Doug Fratus, Leith Merkle, Klondike Kennels, LLC, its employees, owners and agents from any and all liability of any nature, for injury or damage, including that which may result from the action of any animal at Meegan Kennels; and Pet Owner expressly assumes the risk, including financial, of such damage or injury while their pet is in the care of Meegan Kennels.

Owner agrees that their pet may be videotaped and/or photographed. Meegan Kennels will be the owner of the resulting media and the owner grants Meegan Kennels the right to use photos or videos in published material promoting or advertising Meegan Kennels.

Initial here if you do not give permission to have your pet videotaped and/or photographed.

I certify that I have read and understand, and agree to abide by the terms of this agreement

Owner’s SignatureMeegan Kennels Use Only

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Print Name______

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DateSignedDated