Policy Agreement

Client Information

First Name: Last Name:

Email: Phone:

Dog’s Name:

Age: Breed: Sex: Spayed/Neutered? Y N

Vaccination Dates:

Rabies DHPP Parvo(puppies) Bordatella

Vet Name:

Vet Phone:

Do we have permission to contact your Vet for vaccination records? Y N

Agreement to Hold-Harmless Waiver & Acceptance of Risk
I understand that attendance at the Company’s premises is not without risk to myself, members of my family, my guests who attend, or my dog(s), as some of the dogs to which we will be exposed may be difficult to control and cause injury, even when handled with the greatest of care.I am the rightful owner or caretaker of the dog described above and my signature below is sufficient to enter into this agreement for and on behalf of any other owner or representative of the dog.

I hereby waive and release the Company, and its officers, members, managers, agents and employees(including but not limited to Kevin and Kimberly Gilliam)from any and all liability of any nature for injury or damage I or my family, guests, or dog(s) may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while using the facility, attending any training session, or while on the Company’s premises.

In consideration of and as inducement to the acceptance of my application for gym membership, training, or day boarding, I hereby agree to indemnify and hold harmless the Company, and its officers, members, managers, agents and employees (including but not limited to Kevin and Kimberly Gilliam) from any and all claims, or claims by any other person accompanying me to class, or while on the Company’spremises, as a result of any action by any dog, including my own. If to no fault of the Company, it is impossible to open the facility on a given day or complete classes, no fees will be refunded by the Company.

The Companyrequires at least 24 hours notice for day boarding reservation cancellations.Class fees will be refunded or transferred only if the registrant cancels registration no later than 7 days prior to the start of the class. Recurring monthly gym memberships may be cancelled at any time.

I hereby grant permission forthe Company to use photographs and/orvideos of events held on the Company’s premises for any legitimate purpose, including but not limited to marketing.

Signature: Date:

TURN OVER FOR DAY BOARDING POLICIES IF APPLICABLE

Medical Emergency

If in the judgment of Frolick Dogs LLC, a Virginia limited liability company (the “Company”), your dog requires medical care, you agree to be solely responsible for the payment of all medical bills for your dog and you release,and hold harmless, the following: the Company, its officers, members, managers, agents and employees (including but not limited to Kevin and Kimberly Gilliam)of and from any and all responsibility for, orclaims, damages, or debts arising out of or related to such medical care,including, but not limited to, transportation to/from the veterinarian clinic andchoice of veterinarian or animal hospital.

Authorized Pick-up:

List any individuals other than yourself that are authorized to pick up your dog.

Name:

Name:

At any time you may verbally or in writing request that the Company release your dog to someone other than the person’s listed above, however you release the Company and its officers, members, managers, agents and employees (including but not limited to Kevin and Kimberly Gilliam) of any and all responsibility for releasing your dog to any persons that the Company believes to be authorized by you.

Day Boarding Policies:

1. The Company reserves the right to change your dog’s typeof daycare or refuse care if the Company believe it necessary to protect the health and/or well being of your dog, other dogs in the Company’s care, or the Company’s staff.

2. The Company cannot guarantee that toys, blankets or beds left in the Company’s care by you will be in the same condition as brought in; the Company specifically discourage bringing in personal items fromhome.

3. All dogs must be on a leash when entering or leaving the Company’s premises.

4. The dog owner understands the risks involved with communal daycare for dogs. The Company’s daycare dogs play in the indoor agility ring with other dogs under the Company’s supervision. Although the Company will offerreasonable supervision, the unpredictable personality of dogs can sometimes lead to injuryor spreading of illness.

5. The Company reserves the right to adjust its fees for services at any time without prior notice.

6. The Company requiresat least twenty-four (24) hours notice for cancellations.

7. The Company requires a hard copy of yourdog’s current shot records by their first visit. You may authorize the Company to obtain vaccination records directly from the vet listed above.

8. If you or your designee do not pick up your dog within four (4) hours of the agreed upon departure time without notifying the Company, the Company will attempt to contact you by all means possible before surrendering them to Animal Control or other similar government agency. You shall be responsible for any and all fees associated with any such surrender.

Signature: Date:

Form Received: Vaccination Records Received:

Frolick Dogs LLC 3208 Colvin St, Alexandria, VA 22314  703-957-8946