Current Client Form If you are a current client, please fill out this one time form to speed up your check in process. Step 1 of 2 - Owner Information 0% Owner InformationTodays Date: 04/20/2019Your Name* First Last Dogs Name*Phone*Email* Consent1. I consent that I am the legal owner of the above noted dog(s).* Yes 2. I confirm that my dog(s) has all his/her required vaccines including, DHPP, Rabies, and Bordetella.* Yes 3. To the best of my knowledge, my dog(s) is in good health, has not been in contact with any contagious virus’s or illnesses, and is free of ticks, fleas and mites.* Yes 4. I release Lodge Your Paws, it’s staff, owners, and representatives from any and all liabilities apart from negligence, in which I or my dog(s) may suffer from including but not limited to illnesses, injuries or death while participating in daycare, lodging or grooming services.* Yes 5. I understand that it is my responsibility to pick up my dog(s) at the scheduled date and time indicated with Lodge Your Paws and if for any reason I am unable to pick up my dog(s) by closing time, I will notify Lodge Your Paws and my dog will be put into Lodging for the night. If I do not contact Lodge Your Paws, there will be a $50.00 administration fee per night, as well as boarding fees on top of this.* Yes 6. I understand that Lodge Your Paws has reserved the right to permanently remove my dog(s) from daycare if deemed necessary without notice.* Yes 7. I understand that administration of medication is $0.75 per dose.* Yes 8. I authorize Lodge Your Paws to contact my veterinarian or any accessible vet in case of emergency. I agree that I am solely responsible for the medical expenses that may occur.* Yes 9. I release Lodge Your Paws from any liability if my dog(s) is to injure another animal or person and except any medical or legal responsibility of my dog’s actions.* Yes 10. I agree that Lodge Your Paws can take pictures of my dog and use it for whatever purpose.* Yes Authorized persons to pick up my dog, other than myself are:Person:PhonePerson:PhoneABANDONED DOG PROCEDURE:If your dog(s) is left in our facility for more than 7 days past scheduled period of time without contact from you, your dog will be deemed abandoned and we will have the right to give him/her up for adoption whether it is to a new owner, third party, or animal shelter. We will do whatever we can to contact you prior using the contact information you have provided prior to doing so.* Yes Digital Signature* First Last Date*
