Let’s work together!

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Vet Phone Number

(###)

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What services are you interested in? *

Private Training

Board and Train

Overnights

WAIVER OF RISK AND RELEASE OF LIABILITY *

PET HEALTH Client represents that their pet is in all respects healthy and has received all required vaccines (Distemper combo, Rabies, and bordetella(optional) for dogs), current flea protection (Frontline, Advantage, or Revolution for dogs) and that said pet does not suffer from any disability, illness, or condition which could affect said pet, other pets, or Shannon Liles and associates. AUTHORIZATION OF MEDICAL TREATMENT If my dog is ill or injured while under the care of Shannon Liles, she will make every reasonable effort to reach me in pursuant to the contact information provided. However, if unable to reach me, I consent to Shannon Liles seeking appropriate veterinary care and I accept any and all associated expenses. PARTCIPATION AND WAIVER I recognize that there is an inherent risk of injury or illness in any environment associated with dogs in daycare and in boarding environments. I understand that Shannon Liles and associates cannot be held responsible for any injury, illness, or damage to property or humans caused by my dog and that I am solely responsible. I agree to indemnify and release Shannon Liles and associates harmless from any claims made for which they are not ultimately held legally responsible. DISCLOSURE OF BEHAVIOR I certify that my dog has never unduly harmed or threatened anyone or any other pets and I have fully disclosed any potentially harming behavior. I understand that if my dog displays aggressive behavior, that for the safety and health of all, my pet will be confined or be muzzled for the remainder of his/her stay with no offset or deduction in price.

I REPRESENT THAT I HAVE MADE FULL DISCLOSURE AND HAVE READ, UNDERSTAND, AND ACCEPT THE TERMS AND CONDITIONS STATED IN THIS AGREEMENT, AND ACKNOWLEDGE THAT THIS AGREEMENT SHALL BE EFFECTIVE AND BINDING UPON THE PARTIES.

I DO NOT AGREE