Waiver & Consent Form For Boarding

Breed:  ________________________________________________________
Name of Dog: ____________________________________________________
Date of Birth & Sex: ________________________________________________
Colour & Markings:  ________________________________________________
Tattoo # or Microchip #: _____________________________________________

Breed:  _________________________________________________________
Name of Dog: ____________________________________________________
Date of Birth & Sex: ________________________________________________
Colour & Markings:  ________________________________________________
Tattoo # or Microchip #: _____________________________________________

Breed:  _________________________________________________________
Name of Dog: ____________________________________________________
Date of Birth & Sex: ________________________________________________
Colour & Markings:  ________________________________________________
Tattoo # or Microchip #: _____________________________________________

I represent that I am the (1.) Legal owner (2.) Guardian for the above named dog/s.

  1. As owner I give my consent to have above named dog/s to be boarded with Jones Toy Breed Boarding kennel.
  2. As Guardian I have been given consent to sign on the behalf for the above named dog/s to be boarded with Jones Toy Breed Boarding Kennel.

I release Jones Toy Breed Boarding Kennels, its staff, owners, representatives, and agents from any and all liability which I or above named dog/s may suffer including but not limited to injury, sickness, damage or death resulting from participation in daytime boarding, overnight boarding, or outdoor walks.

I represent that the above named dog/s is in good health, is current on all required vaccinations (DHPP, Rabies Bordatella), is free of fleas, ticks, and lice, and as not been ill with any known contagious viruses in the last 30 days.

I understand that while above named dog/s is fully vaccinated, that vaccines are not guaranteed and there is a small risk that the above named dog/s may contract a contagious disease or illness. I agree that should this occur I am responsible for the above named dog’s care and medical attention.

I agree to allow 14 days waiting period after above named dog/s has had their vaccinations to allow the vaccines to reach full protection potential and to ensure the above named dog/s had not has any negative reaction to the vaccines and can not be boarded no less then 7 days after vaccination. Should I allow the above named dog/s to stay at Jones Toy Breed Boarding Kennels less than 14 days after vaccination I understand that the above named dog/s could be at risk of contracting a contagious virus/disease.

I understand that although all dogs are fully supervised that incidents of injuries may occur from playing with the other dogs, which include but not limited to bites, scrapes, scratches, and sprains.

I represent that the above named dog/s is sociable and has not harmed or shown threatening behaviors towards any person or any other dog. I understand Jones Toy Breed Boarding Kennels reserves the right to remove the above named dog/s from the play area and place above named dog in a separate holding area should above named dog/s display any unwanted behaviors, for the safety of the other dogs being boarded.

I allow Jones Toy Breed Boarding Kennels’ owners, representatives, staff to contact my veterinarian or any other accessible vet clinic as deemed necessary should any injuries require medical attention. I agree that I am solely responsible for any medical expenses acquired for the above named dog/s.

I agree to disclose any previous or current medical issues or concerns of the above named dog/s, so that Jones Toy Breed Boarding Kennel’s staff can make a determination of suitability for daycare or offsite boarding.

I release Jones Toy Breed Boarding Kennel’s owners, representatives and staff from any liability should the above named dog/s injure another dog or person and accept medical and legal responsibility for above named dog/s’s actions.

I release Jones Toy Breed Boarding Kennel’s owners, representatives and staff from any liability should death of my dog occur for any reason while in daycare or off-site overnight boarding.

I agree that the above named dog/s may be recorded on video camera or photograph camera and its images may be used for Jones Toy Breed Boarding Kennel’s promotional material.

I agree to pick up the above named dog/s at the agreed planned time. Should I fail to do so and not contact Jones Toy Breed Boarding Kennels four hours prior to the agreed planned pick up date, I understand I will be charged late fees in the amount of $5 for every hour from planned pick up time. I understand that dogs left after 8pm will be charged $21 per dog, in addition to the daily boarding fee and I will not be able to pick up my dog until the following day. Additional fees will be charged for food and any other supplies used for my dog/s boarding should they be needed.

I understand that boarding services are charged on a 24 hour basis, with drop off and pick up permitted only during customer business hours. Additional charges for boarding beyond 24 hours from the time of drop off will be assessed at a corresponding boarding rate. I understand that Jones Toy Breed Boarding Kennels reserves the right to refuse after hours pick up.

I agree to pay for any and all outstanding charges prior to or at time of pickup of my dog. I understand that should I not have provisions for payment at the time of pickup of the above named dog/s, Jones Toy Breed Boarding Kennels reserves the right to withhold the above named dog/s and continue to charge for continued services and any additional fees until payment is made in full. I understand that should I fail to complete payment within 7 days of the notified due date, Jones Toy Breed Boarding Kennels will proceed with the ABANDONED PET PROCEDURE.

In thee event that my emergency contact or any other person I have authorized in writing does not pick up the above named dog/s on the agreed upon departure date, I hereby authorize Jones Toy Breed Boarding Kennel to continue to provide boarding and any additional services at my expense. If such dog/s is deemed abandoned under provincial laws Jones Toy Breed Boarding Kennels will use its discretion permitted by law to follow the Abandoned Pet Procedure.

I will consent Jones Toy Breed Boarding Kennel’s owners, representatives and staff to contact a veterinarian under the following conditions:________________________________________________
________________________________________________________
________________________________________________________

ABANDONED DOG PROCEDURE: Jones Toy Breed Boarding Kennel will attempt to contact you by telephone, email and/or in writing using the information that you have provided, advising you that if the above named dog/s is not picked up within 7 days, the above named dog/s will be deemed to be abandoned and we will deliver the above named dog to a third party adoption partner, animal shelter, or attempt to find a new owner for the above named dog/s. If you fail to pick-up the above named dog/s for any reason, you release Jones Toy Breed Boarding Kennels, its staff, owners, representatives, and agents from further liability and responsibility for the above named dog/s.

With my signature below, I certify that I have read and understand the agreement and waivers. I agree to abide by the regulations and accept all terms and conditions as set out.

Signature:_________________________________________________
Print Name:________________________________________________
Contact Info:_______________________________________________
Date_____________________________________________________

Witness/Received by:_________________________________________
Print Name:________________________________________________
Date_____________________________________________________