Lucky Dog Ranch Daycare and Boarding Contract and Release

LUCKY DOG RANCH DAYCARE AND BOARDING CONTRACT AND RELEASE

OWNER’S INFORMATION Date Pet Owner’s Name Address City State Zip Phone Number Cell Number Email Address (for free pet pics) Vet Name Vet Address and Phone How did you hear about us?

DOG’S INFORMATION Pet’s Name Breed Color Sex Male Female Weight Age Housebroken yes or no Spayed or Neutered: Yes No Has your dog ever bitten a person? Yes No Another Dog? Yes No Has your dog ever jumped over a fence or escaped from your yard? Yes No If yes, please explain: Sibling Pet’s Name Breed Color Sex Male Female Weight Age Housebroken yes or no Sibling Spayed or Neutered: Yes No Has Sibling ever bitten person? Yes No Another Dog? Yes No Has Sibling ever jumped over a fence or escaped from your yard? Yes No If yes, please explain:

Page 1 of 4 VACCINATION HISTORY Vaccinations: Rabies Parvo Bordatella Distemper Copy From Vet: Yes No Heartworm Program: Yes No Date of Last Treatment: Flea/Tick Program: Yes No Date of Last Treatment: Other Medications Other Medical Issues

OWNER RECOGNIZED DOG LIKES AND DISLIKES

Interactions with Other Dogs/Humans Men vs. Women Protective of Owner Yard Food Toys Water Likes/Dislikes Baths Ponds Number of times fed/day Amount per Serving

ADDITIONAL INFORMATION Any special needs or concerns?

Who else is authorized to pick up your dog?

No personal toys or owners are permitted in the play area if the group is playing – dogs can become protective and aggressive.

I understand that Lucky Dog Daycare Ranch Inc is not responsible for any wild animal bites. I agree to allow emergency services to be provided if I cannot be contacted in the case of a life-threatening emergency as determined by the Lucky Dog Daycare Ranch staff. The owner of the pet will be responsible for costs associated with emergency services I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS BACKGROUND STATEMENT IS TRUE AND ACCURATE

Pet Owner’s Signature______Date______

Page 2 of 4 LUCKY DOG DAYCARE CONTRACT AND RELEASE (LDDR Copy)

1. We do not accept Pit Bulls, Pit Bull mixes, Rottweilers, any “bully breed”, or any dog that displays aggression toward other dogs or humans. Any dog that attacks another dog will be banned from the property. 2. Because LDDR is cage free, only well-tempered dogs will be accepted. LDDR reserves the right to reject any dog. 3. Lucky Dog Ranch reserves the right to isolate your pet if he or she initiates aggressive behavior toward other dogs or humans. 4. Lucky Dog Daycare Ranch (LDDR) accepts dogs over 20 pounds. We will make exceptions for sibling dogs that are less than 20 pounds. 5. We only accept dogs that have been spayed or neutered. 6. Proof of current vaccinations must be provided: Rabies, Parvo, Bordatella (canine cough), and Distemper. Email records to: [email protected] 7. LDDR is a smoke free environment. 8. LDDR is not responsible for any wild animal bites that occur on the property. 9. Pet Owner authorizes Lucky Dog Daycare Ranch personnel to take pets for emergency treatment at the nearest facility if Pet Owner cannot be contacted. 10. If pet becomes ill or injured, or if the state of the animal’s health otherwise requires professional attention, LDDR, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the animal, and the expenses thereof shall be paid by the Pet Owner. Pet Owner gives consent to LDDR to act on Pet Owner’s behalf in obtaining emergency veterinary care at Pet Owner’s expense. Pet Owner indemnifies and holds LDDR and its employees harmless for said expenses. 11. Pet Owner agrees to pay all costs and charges for all veterinary costs for the pet during the period the pet is in the care of LDDR 12. Hours for daycare are 7am – 7pm M-F, and Sat & Sun by appointment only. There is an extra charge for early or late drop- offs or pick-ups. 13. There is a responsible adult on the property 24 hours a day 14. Pet Owner agrees to pay the rate for pet care services provided in effect on the date the pet is checked into LDDR. 15. Pet Owner agrees that the pet shall not leave LDDR until all charges are paid to LDDR. 16. Pet Owner consents to LDDR using pet’s likeness and waives all claims of compensation for use of such likeness by LDDR. 17. LDDR shall exercise reasonable care for the pet delivered by Pet Owner to LDDR. Pet Owner recognizes and accepts potential risks involved with pet care services. Pet Owner indemnifies and holds LDDR and its employees harmless for any injury resulting from pet care services. 18. It is expressly agreed by Pet Owner and LDDR that LDDR’s liability shall in no event exceed the lesser of the current chattel value of a pet of the same species or the sum of $500.00 per animal admitted. 19. Pet Owner agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of LDDR, and assume any expense and liability for injury to any human or other animals or damage to facilities caused by the pet. 20. Pet Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances. 21. Pet Owner specifically represents to LDDR that, to Pet Owner’s knowledge, the pet has not been exposed to any contagious diseases within a thirty-day period prior to check-in. During the period of the Agreement, Pet Owner also agrees to notify Facility of any known exposure of pet to a communicable disease and hold pet out of attending LDDR until pet is symptom free for a minimum of seven (7) days or with written veterinary clearance. Pet Owner further agrees to maintain currency of vaccinations as required by LDDR policy. 22. 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 Pet Owner and LDDR. 23. 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 to this Contract, shall be settled in accordance with the rules of the American Arbitration Associations, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of the award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.

I HAVE READ, FULLY UNDERSTAND AND ACKNOWLEDGE THE DISCLAIMERS ON THE AGREEMENT ATTACHED HERETO AND ENTITLED LUCKY DOG DAYCARE CONTRACT AND RELEASE, FURTHER, I HAVE RECEIVED A COPY OF LUCKY DOG DAYCARE RANCH CONTRACT AND RELEASE.

Pet Owner’s Signature______Date______Page 3 of 4 LUCKY DOG DAYCARE CONTRACT AND RELEASE (Pet Owner’s Copy)

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