DENEGAR KENNELS BOARDING/ PET SHUTTLE
803-642-7909 OR TOLL FREE 1-866-962-PETS
Zip:________ Home Phone: ___________________________________
Work or Cell Phone:________________
Breed or type:_______________________________________
Color: ____________________________ Birth date___________________
Circle one of the following: Neutered Male / Spayed Female
Are you using flea control? ______ yes or _________no
Heartworm preventative? ______ yes or _________no
Has your pet been checked for heartworms? ______ yes or _________no
Special instructions for your caged pets
Is your pet housebroken / litter box trained? Yes _____ No _____
Has your pet ever had Kennel Cough Disease ? Yes___ No _____
Does your pet cough, sneeze, wheeze or exhibit any asthmatic symptoms? Yes /No
If yes, how long have symptoms been present?
Has your pet ever been boarded or attended day care? Yes _____ No
Were there any problems with your dogs behavior when boarded?
Please answer honestly. We will still kennel your pet, but we need to be aware
of problems for the safety of your pet and others so that proper accommodations
can be made. Example: You have an escape artist, or food aggressive, and etc....
Has your pet ever bitten a person? Yes _____ No _____
Has your pet ever exhibited aggressive behavior towards people or other pets?
Yes _____ or No______ If yes, please explain below…
Has your pet ever been bitten, abused or attacked by another animal?
Yes ____________ No _________
Medical and Emergency Information
Vet or Clinic_________________________________________________________________
State: __________________________ Zip:______________
Vaccinations: Please list the most recent date of the following vaccinations:
Dogs: Rabies __________ DHLP __________ Parvo __________
Cats: Rabies ___________ FVRCP ___________
Feline Leuk Testing ___________
Please describe any medical or physical problems:
3. Emergency Contact (if other than Owner:) Name and Phone#
Please initial beside each term to accept it.
4. Emergency Medical Care, If, in our judgment, your pet requires medical care and we are unable to reach you, please indicate below whether you want us to take your pet to a veterinarian or animal hospital.
YES _____ By checking “YES”, you agree to be solely responsible for the payment of all medical bills for your pet, and you release Denegar Kennels, its officers, directors, agents and employees of and from any and all responsibility for, or claims, damages, debts, arising out of or related to such medical care, including, but not limited to, transportation to/from the veterinarian clinic
and choice of veterinarian or animal hospital.
NO _____By checking “NO”, you agree to release Denegar Kennels, of and from any and all responsibility for or claims, damages, debts; arising out of, or related to Denegar Kennels not providing or obtaining medical care for your pet, and you acknowledge that Denegar Kennels is not required to give any medical aid.
5. Pick-up of your pet: Denegar Kennels will only release your pet to:
______By checking here, you may verbally (by telephone) or in writing (by facsimile or otherwise) request that Denegar Kennels release your pet to someone other than the person(s) listed above, and you release Denegar Kennels of and from any and all responsibility for releasing your pet to any person to be authorized by yourself.
Please list any special instructions here:
______ Denegar Kennels reserves the right to immediately change your pet’s type of boarding/day care if we believe it is necessary to protect the health and well-being of your pet, other‘s pets, or our staff.
______Denegar Kennels cannot guarantee that toys, blankets, or beds will be kept in the same condition as brought in.
______All pets must be up to date on all vaccinations!
______I understand that Denegar Kennels will not be held accountable by me or any party with an interest, in my pet, if something were to happen during transporting this animal to or from our kennels. I understand that this is an acceptable risk taken by me, and I will be required to sign a request and release, when asking for my pet to be picked up or delivered.
By signing below, a. You indicate your agreement with all the terms hereof. b. You authorize Denegar Kennels to obtain medical and vaccination records for your pet from the veterinarian listed above and you hereby authorize your veterinarian to provide these records to Denegar Kennels. c. You release, indemnify and hold Denegar Kennels harmless from any and all manner of damages, claims, losses, liabilities, costs, or expenses, causes of action or suits, whatsoever in law or equity (including, without limitation,
attorney’s fees and related costs) arising out of or related to the services provided by Denegar Kennels, except, those which may arise from the sole gross negligence or intentional and willful misconduct of Denegar Kennels.
Including, without limitation;
(I) any inaccuracy in any statement made by ourselves or information provided by you to Denegar Kennels.(II) your pet, including, but not limited to, destroys property, bites, and has a part in the transmission of disease, III) and action by yourself which is in breach of the terms and conditions of this agreement.
d. This Agreement covers the current relationship between Denegar Kennels and yourself. Each time you bring your pet to Denegar Kennels, you affirm the terms of this agreement and the truthfulness and accuracy of all statements you make in this agreement.
I UNDERSTAND BY SIGNING THIS AGREEMENT I AM RESPONSIBLE FOR THIS BILL AND HEREBY AGREE TO PAY IT. I ALSO UNDERSTAND I AM TO KEEP IN CONTACT WITH DENEGAR KENNELS ABOUT PLANNED DATES TO PICK UP MY PET. IF REQUIRED, I AGREE TO MAKE ADVANCED PAYMENTS FOR MY PETS STAY. IF AT ANYTIME MORE THAN TEN DAYS PASS WITHOUT PAYMENT FOR MY PETS STAY, AND WITHOUT CONTACT (AND PAST EXPECTED PICK UP DATE), DENEGAR KENNELS HAS ALL RIGHTS AND PERMISSION TO TAKE MY PET TO THE LOCAL SHELTER AND DENEGAR KENNELS WILL NOT BE RESPONSIBLE IF MY PETS ARE ADOPTED OR EUTHANIZED.
PLEASE READ: You are charged for the day you come in, (REGARDLESS OF THE TIME), and normally per 24 hours -with special rules on Sunday. Examples: (1) Check in 8:30am Friday - check out 5:55pm Tuesday. You will be charged for 5 days. After 8:30am on Tuesday you entered into another 24 hour period. (2) Check in time: Friday at 7pm - Check out time: Sunday at 11am. You will be charged for three days stay. You are paying as if they are staying until Monday, and they are welcome to do so, but most kennels are closed on Sunday and you would have to wait to pick them up anyway. I am allowing you to pick-up on Sunday for your convenience only, so it doesn’t take from your busy weekly schedules. You are not saving any money by picking up on Sunday.
PLEASE CALL BEFORE DROPPING OFF OR PICKING UP. OTHERWISE YOU MAY JUST SHOW UP AND FIND A LOCKED GATE. I AM EXTREMELY FLEXIBLE AND WOULD LOVE TO HAVE YOUR PET!
COMPANY USE ONLY: Employee’s name/initials:___________
THANK YOU AND WE LOOK FORWARD TO PROVIDING YOU WITH THE BEST SERVICE POSIBBLE! FEEL FREE TO STOP BY AND VISIT OUR KENNELS ANYTIME! THANK YOU, PAULA DENEGAR AND THE STAFF AT DENEGAR KENNELS