All Breed K9 Academy
Owner's Name______Drop off date:_____ Pick up date:_____
Address______
Home Phone ______Alternate Phone ______
Emergency Contact______Phone ______
Dog’s Name: ______Breed: ______Sex: M or F Age: ___
Veterinarian Clinic ______
___Spayed / Neutered ? ___Rabies Shot? ___Bordetella (Kennel cough) Shot?
___DHLPP Shot? (Distemper, Hepatitis, Leptospirosis, Parvovirus, Parainfluenza)
Terms and Conditions:
I, ______, as the legal owner of the above-mentioned pet(s), having carefully read and understand this agreement, do hereby grant All Breed K9 Academy, Peter B Olson, permission to take any and all action necessary to secure the well being and health of the above mentioned pet(s) including any medical attention deemed necessary. I agree to reimburse All Breed K9 Academy for any expenses incurred in securing the well being and health of my pet(s). I agree to reimburse All Breed K9 Academy for any property damage caused by my dog during day-care or boarding.
All charges incurred by Owner shall be payable upon pickup of pet(s). If the pet(s) becomes ill or if the state of the animal's health otherwise requires professional attention, Kennel, in its sole discretion, may engage the services of a veterinarian of its choosing, or administer medicine, or give other requisite attention to the animal, and the expenses thereof shall be paid by Owner. IN ADDITION, I HEREBY RELEASE AND DISCHARGE ALL BREED K9 ACADEMY, OWNERS, EMPLOYEES OR ITS ASSIGNS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, LEGAL REPRESENTATIVES, OR ASSIGNS NOW HAVE OR MAY IN THE FUTURE HAVE FOR INJURY, LOSS, DAMAGE FROM DISEASE, DEATH, RUNNING AWAY, THEFT, FIRE, INJURY TO PERSONS, INJURY FROM OTHER PETS, TO MY PET RESULTING FROM MY PET'S ACTIVITIES AT ALL BREED K9 ACADEMY WHETHER OR NOT RESULTING FROM THE NEGLIGENCE, GROSS NEGLIGENCE OR MISCONDUCT OF ANY PERSON, OR THE ACTIONS OF ANOTHER ANIMAL. I also agree to indemnify and hold harmless All Breed K9 Academy, its owners, employees and/or its assigns, from any and all claims due to any damage the pet may cause to any person or other animal while on the All Breed K9 Academy premises. In the event All Breed K9 Academy, deems it necessary to employ legal counsel to protect their rights under this agreement, the owner/agent of the pet agrees to pay all expenses incurred by All Breed K9 Academy to enforce their rights under this agreement including but not limited to costs and reasonable attorneys fees.
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND I HAVE SIGNED IT OF MY OWN FREE WILL.
Pet Owner's Signature...... Date……………