Client Information



Client Information

Name: ___________________________________________________________

Second Owner’s Name: ____________________________________________

Street Address: ___________________________________________________

City: ___________________________ State: ______ Zipcode: ____________

Home Phone: _____________________________________________________

Cellular Phone: ___________________________________________________

Work Phone: _____________________________________________________

E-Mail Address: ___________________________________________________

Emergency Contact (Other than Self): ______________________________

Emergency Phone Number: _______________________________________

Preferred Phone to Contact: ______________________________________

Persons Authorized to Pick-Up Pets

1. ____________________________________________________________

2. ____________________________________________________________

3. ____________________________________________________________

4. ____________________________________________________________

5. ____________________________________________________________

Pet Information

Pet Name #1: _______________________________________________

Dog or Cat: __________________________________________________

Breed: _______________________________________________________

Color: _______________________________________________________

Markings: ____________________________________________________

Weight: ____________________ Date of Birth: ____________________

Gender: Male Neutered

Female Spayed

Pet Name # 2: ________________________________________________

Dog or Cat: __________________________________________________

Breed: _______________________________________________________

Color: _______________________________________________________

Markings: ___________________________________________________

Weight: ____________________ Date of Birth: ____________________

Gender: Male Neutered

Female Spayed

Veterinary Care Release Form

I (please print name), ____________________________________ give permission to Pal’s Inn Pet Resort and employees of Pal’s Inn Pet Resort to take my pet(s): ____________________________ to his/her local veterinarian for necessary treatment due to the symptoms that he/she has been experiencing. I understand that the veterinary hospital will bill my credit card or bill me at a later date.

Print Name: ______________________________________________________

Sign Name: _______________________________________________________

Date: ___/___/________

Pal’s Inn Pet Resort Service Contract

This is a Contract between Pal’s Inn Pet Resort LLC (herein after called “PIPR”) and the pet owner whose signature appears below (hereinafter called “Owner”)

1. Owner agrees to pay the rate for boarding in effect on the date pet is checked into PIPR (as posted).

2. Owner further agrees to pay all costs and charges for special services requested, and all veterinary costs (in the event of an emergency situation-See #10 below) for the pet during the time said pet is in the care of PIPR.

3. Owner further agrees that the pet shall not leave PIPR until Owner pays all charges to PIPR.

4. By signing this Contract and leaving his or her pet with PIPR, Owner certifies to the accuracy of all information given about said pet on Contract.

5. PIPR shall exercise reasonable care for the pet delivered by the Owner for boarding or day care. Owner understands and acknowledges that there is always the possibility of injury to the pet either to himself or by another dog, and that dogs may be unpredictable. Owner hereby releases PIPR from any and all liability (and all of its care providers, owners, officers and employees) for any injury to Pets associated with being in a play group. It is expressly agreed by Owner and PIPR that the liability shall in no event exceed the lesser of (a) the current chattel value of a pet of the same species or (b) the sum of $200.00 per animal boarded. The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of PIPR.

[Owner initial: _______]

6. Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances.

7. Owner specifically represents to PIPR that the pet has not been exposed to rabies or distemper within a thirty day (30) period prior to boarding.

8. In the event that any medication is to be administered to the pet, thorough and written instructions must be presented to PIPR at the time of registration or subsequent entry. PIPR will take all reasonable care to follow and administer said medicine. However, owner retains complete responsibility for the administration of said medicine and holds harmless any and all owners, partners, and employees of PIPR. [Owner initial: _______]

9. All charges incurred by Owner shall be payable upon pick-up of pet, or when billed by PIPR at address listed on contract. PIPR shall have, and is hereby granted, a lien on the pet for any and all unpaid charges resulting from boarding pet at PIPR. The Owner hereby agrees that in the event that boarding charges are not paid when due in accordance with the contract, PIPR may exercise its lien rights upon ten (10) days written notice given by PIPR to Owner by certified mail to address shown on contract. PIPR may dispose of pet for any and all unpaid charges, at private or public sale, at the sole discretion of PIPR, and the Owner specifically waives all statutory or legal rights to the contrary. If such sale shall not secure a price adequate to pay such costs of board or other charges delinquent, plus cost of sale, the Owner shall be liable to PIPR for the difference. All monies realized by PIPR at such sale, over and above the charges due and costs of sale, shall be paid by PIPR to the Owner.

10. If pet becomes ill or if the state of the animal’s health otherwise requires professional attention, PIPR, in its sole discretion, may engage the services of the pet’s regular veterinarian or the veterinarian closest to the PIPR facility and the expenses thereof shall be paid by the Owner. [Owner initial: _______]

11. This Contract contains the entire agreement between the parties. All terms and conditions of this Contract shall be binding on the heirs, administrators, personal representatives and assigns of the Owner and PIPR.

12. Any controversy or claim arising out of or relating to this contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party of this contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of his award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.

13. In any litigation arising out of this contract, the prevailing party shall be entitled to receive reasonable attorney’s fees and costs.

PIPR Rep.: ______________________ Pet Owner: ____________________________________________ Date: ___ /___ /___

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