WAGSINN NEW CUSTOMER INFORMATION Customer Information Last Name First Name Address City State Zip Home Phone Cell Phone Your Email (required) Referral Emergency Contact Emergency Phone How often do you require boarding? Are you interested in adopting another dog? Are you interested in daycare? Pet Information Pet Name Breed Color Sex Birthdate Spayed/Neutered YesNo Vet Information Business Name Address City State Zip Phone Contact Medical Concern Pet Information Disclosure Owner Pet Name Length of time owned Physical Description & Breed Feeding Instructions If you have 2 or more dogs, do you feed together? Any problems feeding your dogs in the same room? Describe: Food and Meals Dry: Brand Dry: Amount Dry: Breakfast Dry: Dinner Wet: Brand Wet: Amount Wet: Breakfast Wet: Dinner Name any food or treats your dog is not allowed to have Medications and Multivitamins Dosage Purpose for medication Naps and Bedtime Sleeping arrangements at home suitecomfy cratecolossal cratehoundstooth Your dog's temperament and personality traits Your dog doesn't like: (checkmark what applies to your dog) Baths Ears touched Sudden moves Other dogs Loud noises People near food Strangers Held by the collar Sharing dishes or water bowls Has your dog ever: (describe even mild situations) Attacked or bit someone Attacked another animal Injured self / escaped crate out of fear or boredom Jumped over a fence, if so, how high was the fence? Tried to dart out open doors Acts out with excessive barking when crated or left alone? Has your dog interacted with other dogs? Please describe: Has your dog ever been boarded? If so, please describe his experience. What are your expectations from a dog lodging facility? Comments and Special Restrictions WAGS INN DOG BOARDING Client Contract Please read the following information carefully before initialing and signing below. Your initials and signature confirm that you have read, understand, and agree to the following: Your dog will be with other dogs in a fenced in yard. Although every attempt is made to socialize the dogs, problems may occur. Wags Inn needs to be informed if your dog should be isolated from other dogs. WagsInn, agrees to exercise all due and reasonable care of your dog. Should your pet be injured or ill, WagsInn will attempt to notify you. It will be at our discretion to determine the Vet or Animal Hospital your dog will be taken to. We shall have the right to administer medicine or give other advisable attention. Any vet bill will be the responsibility of the owner. Although your dog/s are vaccinated for kennel cough there are many strands the vaccination does not cover and your dog may be exposed to such virus or any canine virus. The boarding charge for your dog will be $45.00 to $55.00 per night per dog. (Depending on sleeping arrangements). People-only dogs will be an additional $10/day. Pick up before 10am will be at no charge for that day. Pick-ups after 10am will be a full days charge. There are no early pick ups on Sunday. Pickups and drop offs on Sunday are between 4pm and 5pm. WagsInn is not open on holidays. Owner is responsible for providing food. A daily fee of $3.00 will be added to your bill if WagsInn provides the food. Payment in form of cash check visa or master card is due at pickup or at the time of delivery at your home. WagsInn provides transportation to and from Wags Inn. Lori Wolcott or agents of WagsInn are not to be held responsible for any injury during transport. Please Draw Initials As owner of the pet specified above, the undersigned does acknowledge that there is a risk of confrontation between my dogs and other dogs residing at the Wolcott premises, and I do therefore wave, give up and discharge Lori Wolcott individually and doing business as WagsInn, her agents and assigns from any claim of liability resulting from injury to my said pet, my pet running away theft, fire, illness or injury to persons. I do further agree to indemnify and hold harmless the said Lori Wolcott from and against any veterinary medical bill which might be reasonably incurred by Lori Wolcott, and her agents for the benefit of my said pet and do agree to pay the same. Please Draw Your Signature Date: Emergency Medical Authorization If the staff of WagsInn believes your dog requires medical attention, WagsInn will promptly seek a vet. My staff or I will notify you immediately after we have the diagnosis. In case we cannot reach you, WagsInn will notify your emergency contact. However, if we cannot reach anyone, the decision of treatment will be at Wags Inn's discretion along with the advisement of the vet. As the owner, I give authorization to Lori Wolcott individually and doing business as Wags Inn, and her agents to decide in the best interest of our dog any medical treatment our dog should require. As the owner, I authorize the Veterinarian to perform any procedure or surgery necessary for the health and well being of my dog. Any bill incurred is the responsibility of the owner. Print name and dog's name Please Draw Your Signature Date: Personal cell phone Emergency contact Emergency contact cell phone