Moulton CollegeAnimal Therapy Centre
Consent for Grooming
Owners Name:Telephone Number:
Address:
Dog’s Name:Breed:
Age:Sex:
History of illness/injury:
Please read the following consent. If you have any queries please do not hesitate to ask any Therapy Centre staff.
- I am the owner or guardian of ……………………………………..and have authority to give this consent. I am over 18 years of age.
- I understand that during the grooming sessions, professional, qualified staff supervise treatments for the animal at all times.
- In the event of any unforeseen circumstances I acknowledge that every endeavour will be made to contact me by telephone.
- I understand that all fees must be settled at the end of treatment.
- Please tick to confirm your dog is up to date with current vaccinations:
Or
Due to the high number of dogs using Animal Therapy Centre my unvaccinated and/or homeopathically treated dog is at risk particularly from Parvo Virus, Leptospirosis, Distemper and Hepatitis/Adeno virus. I accept that whilst every effort is made to maintain good hygiene this centre cannot be held responsible if for any reason my dog contracts any such virus or disease.
Moulton College states that owners and animals use the grooming facilities at their own risk. Although the college will take every precaution to prevent injury, due to the nature of the activity, if any injury does occur, we cannot accept responsibility. The college cannot accept responsibility for any injury suffered by owners or animals whilst on site. We cannot accept responsibility for any loss or damage to personal belongings whilst on MoultonCollege grounds. I have read and agree to the terms and conditions.
Please tick to confirm agreement of the following statement: In the unlikely occurrence of injury to the animal, if the owner/agent of the dog cannot be contacted, the College have the right to take it to the on site veterinary centre for treatment. The owner/agent of the dog will be responsible for any fees incurred.
- I have read and understand this form and hereby voluntarily give my consent.
Signature of Owner: ……………………………………… Date:……………
Contact numbers on day of grooming: Landline:…………………. Mobile:………………….