Client Name (required) Phone Number Has your address or vet info changed since your last Grad School stay? —Please choose an option—YesNo Email Address (required) Dog Name Dog's Aprox. Age and Weight How Often Does Your Dog Eat? —Please choose an option—Once in MorningOnce in EveningTwice a DayThree Times a Day How Much at Each Meal? Requested Start Date of Stay Drop Off Time (Drop offs before Noon will be charged an extra night) Requested End Date of Stay Pick Up Time (Pick Ups after 6pm will be charged an extra night) Additional Notes For Us Is your dog up to date on all vaccines? —Please choose an option—YesNo Date of Last Flea Prevention Medicine (*If fleas are found while dog is with us, we will treat the dog at the owner's expense unless directed otherwise) Date of Last Heartworm Prevention Medicine Is your dog on any medications currently? If yes, provide name and dispensing instructions. I authorize K9 Solutions of Central North Carolina to dispense medications as directed above. I Agree I authorize K9 Solutions of Central North Carolina to take my pet to my veterinarian on file for veterinary care if, in their opinion, care is needed and I will be responsible for payment for treatment. If it is an immediate emergency and my regular clinic is not open or it is a matter of life or death of the pet, I give K9 Solutions of Central North Carolina the authority to take my pet to the nearest emergency clinic and I assume all financial responsibility for any bills incurred up to the amount authorized below. I also understand that K9 Solutions of Central North Carolina will be released from all liability related to the treatment, expense or loss of my pet. I Agree I authorize K9 Solutions of Central North Carolina to approve treatment up to: (provide $ amount) I understand that training is not without risk to my dog. I hereby waive and release K9 Solutions of Central North Carolina LLC, its officers, employees, owners, members, contractors, and agents from any injury or damage resulting from the action of the dog, and I expressly assume the risk of any such damage or injury while attending any training session, or while on the training grounds or the surrounding area thereto. In consideration of and as an inducement to the acceptance of my application for training I hereby agree to indemnify and hold harmless K9 Solutions of Central North Carolina LLC, its officers, employees, members, contractors, agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or while on the grounds or surrounding area thereto as a result of any action of any dog, including my own. I Agree Δ Like this:Like Loading...
