Boarding Intake/ contract Form Please fill the form below: First priority accessyou will receive notification when we reach half capacity on major holidays including Christmas, Thanksgiving, New years, 4th of July. Guardian's Name * First Name Last Name Email * Cell Phone * Country (###) ### #### Work Phone * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Dog Info Name Age Breed Sex Male Female Spayed/Neutered Yes No Emergency Info Client's trip location and address Phone at trip location Emergency Contact & Relation Emergency Contact's Phone Alternate Emergency Contact Alternate Emergency Contact's Phone Vet Office/Vet's Name Vet Address Address 1 Address 2 City State/Province Zip/Postal Code Country Current medications and reasons for meds Other important medical history notes Feeding Instructions Dog's regular food How much and how often to feed per day Dog's regular treats Dietary/Treat Restrictions Other treats ok? Yes No Exercise & Mental Stimulation Instructions # of walks/day Duration of walks/day Other modes of exercise or details? Behavioral Instructions Known behavioral issues Special instructions/notes regarding how you would like us to handle these issues Dog Sitting/Boarding Service Details First visit day MM DD YYYY Last visit day MM DD YYYY # of visits/day # of resulting days Rate $ Total Due $ Boarding Service Details Arrival pick-up date MM DD YYYY Arrival pick-up time Hour Minute Second AM PM Departure drop-off date MM DD YYYY Departure drop-off time Hour Minute Second AM PM # of resulting days Rate $ Total Due $ Payment & Cancellation Agreement Form of payment * Cash Check Credit Card Paypal Google Wallet Better Walker Bill Me Other By checking "I agree" below, You agree with the terms of payment and cancellation. You agree to pay in full for boarding or sitting services at due date equal to Ten (10) full days prior to the first day of service. You agree to request to re-schedule or cancel services Five (5) days before the first day of services to receive a full refund. You agree that You will not receive a full or partial refund for re-scheduling or cancelations outside of the Five (5) day term. * I have read and agree to these payment information and agreement terms. Waiver & Policies B inn B Kennel club , will endeavor to offer only sound, safe, and responsible care for my dog(s). 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 B-inn-B of any and all claims of injury, expense, costs, or damages caused by the actions of my dog while under B-inn-B kennel club care. I have been told by B-inn-B and understand the inherent risks of owning a dog, including but not limited to the risk of dog bites to others or myself. I recognize that B-inn-B 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. * I have read and agree to the above Waiver and Policy terms I authorize emergency medical care to be provided for my dog(s) by the above-named veterinarian, or an appropriate alternate to be determined by B-inn-B in the event my regular veterinarian is not available or that closer care is required. I will reimburse B-inn-B for any charges related to emergency care. I authorize B-inn-B to administer or seek 1st aid and resuscitative care for my dog(s) as determined appropriate by B-inn-B and I agree to indemnify and hold harmless B-inn-B for all and any results thereof. I DO NOT authorize B-inn-B to administer or seek 1 st aid and resuscitative care for my dog(s) as determined appropriate by B-inn-B I agree to indemnify and hold harmless B-inn-B for all and any results thereof. Client authorizes this contract agreement to be valid approval of future services permitted by B-inn-B to accept telephone, email, or online appointments for services invoiced accordingly. Terms and prices are subject to change. In such event, B-inn-B will provide client will advance written notice. I agree Thank you!
