ODS Intake: One Dog Sitter
CLIENT AND PET INFORMATION
Client Name: _________________________________
Address: ___________________________________
City, State, ZIP: ____________________________
Phone: ____________________________________
Email: ____________________________________
Pet Name: __________________________________
Breed: ____________________________________
Age: ______________________________________
Weight: ___________________________________
Emergency Contact Name: ______________________
Emergency Contact Phone: _____________________
Veterinarian Name: ___________________________
Veterinary Clinic: ____________________________
Veterinary Phone: ____________________________
WAIVER AND RELEASE OF LIABILITY
I, the undersigned pet owner ("Owner"), hereby acknowledge and agree to the following terms and conditions for in-home dog boarding services provided by One Dog Sitter ("Service Provider"):
I understand that boarding my pet involves inherent risks, including but not limited to injury, illness, escape, death, or behavioral changes. I voluntarily assume all risks associated with the boarding of my pet.
I hereby release, waive, discharge, and hold harmless the Service Provider, its owners, employees, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury that may be sustained by my pet or myself during the boarding period, except in cases of gross negligence or intentional misconduct.
I authorize the Service Provider to seek emergency veterinary care for my pet if deemed necessary. I agree to be responsible for all veterinary costs incurred. If I cannot be reached, the Service Provider may use their discretion in seeking appropriate veterinary care.
I certify that my pet is in good health, current on all vaccinations, and has no history of aggressive behavior toward humans or other animals. I agree to provide accurate information about my pet's medical history, dietary needs, and behavioral characteristics.
The Service Provider is not responsible for any damage to or loss of personal property brought with the pet, including but not limited to toys, bedding, leashes, or food containers.
I agree to indemnify and hold harmless the Service Provider from any claims, damages, or expenses arising from my pet's actions or behavior during the boarding period.
EMERGENCY VETERINARY AUTHORIZATION
I hereby authorize the Service Provider to act as my agent in seeking emergency veterinary treatment for my pet. I understand that I will be responsible for all costs associated with such treatment.
Spending Limit for Emergency Care: $__________
Special Medical Instructions:
ACKNOWLEDGMENT
I have read and understand this waiver and release of liability. I am voluntarily signing this agreement and understand that it affects my legal rights. I acknowledge that no oral representations, statements, or inducements apart from this written agreement have been made.
Owner Signature: ___________________________
Date: ___________________________________
Service Provider Signature: __________________
Date: ___________________________________
This waiver shall remain in effect for all future boarding services unless revoked in writing.