Boarding Consent/Registration Form

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Boarding Consent/Registration Form Café Free Boarding (Daycare dogs onl Traditional Boarding Thank you for choosing Rex s Place and Rex s Place Boarding House to care for your pet(s) while you re away. Your dog s safety and happiness is our primary concern and we take our job very seriously. We hope the information below will be helpful in getting ready for your dog s stay with us. Name: 2 nd Dog Name: Rex s Place Cage Free (daycare clients only) Arrival Date: Departure Date: Departure Time: Rex s Place Boarding House Arrival Date: Please see below for available hours Arrival Time: Departure Date: Please see below for available hours Departure Time: Reservation information: Check in Times: Reservation Information: Check in Times:

Monday Friday: 6:30 am 11:00 am There are no check in s for cage free boarding on Saturday or Sunday Dogs picked up after 11:00 will incur a ½ day charge. No pickups after 6:00 pm Monday Friday: 7:00 3:00 Sat/Sun and Holidays: 9:00 12:00 am 3:00-5:00 pm Dogs picked up after 12:00 pm will incur a $20.00 charge. No pickups after 5:00 pm A non-refundable deposit of $75.00 is required to hold your spot. This will be deducted from the balance of your stay. A non-refundable deposit of $110.00 is required to hold your spot. This will be deducted from the balance of your stay. A credit card is required for all boarding guests. The balance of your stay will be charged at the time of your departure. Credit Card #: Exp CVV Requirements for Boarding Vaccinations: Proof of current vaccinations is required for any pet that overnights with us. The following vaccinations are required: Bordetalla (kennel cough) Distemper Parvo Leptospirosis Rabies If your pet is not up to date on these vaccines, he/she will not be allowed to stay with us. Flea Medication: All pets boarded at Rex s Place Boarding House are required to be treated for fleas with a prescription strength product. If any fleas are noticed on your pet, Rex s Place Boarding House will treat your pet with the treatment of our choice (depending on your dogs weight) and the cost will be applied to your balance. Heartworm/Intestinal Parasite Medication: All pets staying at Rex s Place Boarding House are required to be on a heartworm prevention plan to protect not only your dog but also the other dogs staying with us. Please provide proof of purchase of your heartworm prevention medicine and a negative heartworm test us within 24 hours of your stay. Behavior: For the safety of our staff and other guests, Rex s Place Boarding House reserves the right to refuse to board any animal that is deemed to be overly aggressive or is seen as having severe behavioral problems.

Consent Forms and Information Forms: Owners are required to fill out and complete all necessary forms for their pet to overnight with us. Food: Our boarding rates do not include furnishing food for your pet. To be honest, there are so many allergies out there, we believe it is best for your dog to stay on his own food during his stay. We require using Zip-Lock bags with pre-measured portions for every meal. Please make sure to pack some extra portions in case your stay has to be extended If your dog has to eat a special food just tell us what it is, how we should keep it (e.g. refrigerate) and we are good to go. Medication: Pet Owners are required to provide all medication needed for the duration of your dogs stay. If you use a special food or treat to administer medications to your pet, please make sure you bring those with you. If your pet s medication is a controlled substance, the owner as well as the staff, to verify quantities, will count the medication. We will only accept the amount of controlled substance needed for the duration of your pup s stay. If your pet requires insulin injections, you are required to supply the insulin as well as syringes and needles for the duration of your pet s stay plus a couple of extra days in case your dog s stay is extended. In order to more closely monitor the eating, drinking and bathroom habits of a dog with diabetes. They will be required to board by themselves. Owner Responsibility Check List (Cage Free Boarding) Pre-packaged pet food and treats, along with feeding instructions are provided Medication for their stay is provided with clear instructions Completed and signed boarding contract Nothing else is required Owner Responsibility Check List (Kennels) Pets are up to date on all the required vaccines Pets are treated with appropriate flea prevention Pets are treated with approved Heartworm prevention Emergency contacts are provided Signed social media form Pre-packaged pet food and treats, along with feeding instructions are provided Completed and signed boarding contract Medication for their stay is provided with clear instructions 3 of your pet s belongings (e.g. nonsqueaky toys, blankets, etc.) to bring with them Boarding Consent

This boarding contract ( Agreement is made this day of, 20. By and between Rex s Place (RPCF) and Boarding House (RPBH) and (hereafter known as Pet Owner), WHEREAS RPCF and RPBH wishes to provide pet boarding services and Pet Owner wishes to accept such service on terms and under the conditions recited below. The parties, intending to be legally bound, hereby agree as follows: Prices for Services are detailed on our Rate Card and posted on our Rex s Place website and are subject to change. A non-refundable deposit is required to secure your space when the reservation is made. RPCF and RPBH reserves the right to not accept any pet into the boarding house for any reason. All rules of the facility are subject to changes and at the sole discretion of RPCF and RPBH. Pets are boarded in cage free facility with a staff member at all times or kennels where they will be left unattended overnight. Should a medical emergency occur, Pet Owner gives RPCF and RPBH permission to treat pet(s) and to pay any charges incurred for the treatment of the pet(s) in full at the time of the pet(s) pickup. Pet Owner agrees to hold RPCF and RPBH, its members, directors, officers, agents, employees and lessors of the premises from any and all claims of loss or injury (including legal fees) which may be alleged to have been caused directly or indirectly to any person or thing by the act of the pet and Pet Owner personally assumes all responsibility and liability for any such claim.. Pet Owner understands that while RPCF and RPBH takes all reasonable steps to avoid communicable diseases, there is still a risk of acquiring such a disease while boarding. Pet Owner assumes all the risks and accepts the responsibility for the cost of all treatments. Pet Owner further agrees to hold the owners and staff of RPCF and RPBH harmless for expenses incurred for such treatment). Pet Owner agrees that RPCF and RPBH is not responsible for the loss or damage of any belongings, such as blankets or toys that are brought with the pet(s). Pet Owner certifies that he/she is the actual owner of the pet(s) or is the duly authorized agent of the actual owner whose name is entered above. Pet Owner represents that the pet is free of any infectious disease and has been vaccinated with all of the required vaccinations as outlined in the Requirements registration. Pet Owner is aware that there is an inherent risk of illness and injury when dealing with animals. Pet Owner understands that if pet is not picked up 5 days after agreed upon pick-update, the pet shall be determined to be abandoned and Pet Owner relinquishes all claims to the animal, but shall not be relieved of the contractual liability of any treatment, boarding, or care provided. Pet Owner represents that the information provided on all the forms signed and submitted to RPCF and RPBH are true and that RPCF and RPBH is reasonable to rely on the accuracy of the supplied information. Pet Owner has read and understands the Requirements for Boarding at RPCF and RPBH.

I have read and understand the terns set forth above. I agree to abide by all the terms, conditions and statements of the RPBH Contract. Owners Signature - Date - Printed If you re cage-free boarding with us, you re done.!!!

First Time Guests Thank you for choosing Rex s Place Boarding House for your overnight stays. For first time boarders with us, we need the following information. We ll keep it on file so if you stay with us again, we ll have it ready. Social Media Please initial to select whether your approve or decline to give us permeation to use your pet s photos as outlined below: Agreed I Decline I hereby give Rex s Place Boarding House permission to use photographs of my pet on Facebook or other social media applications. I grant Rex s Place Boarding House permission to publish photographs of my pet for promotion of the organization in printed publications and photographic displays on the Rex s Place website. Owner Signature - Date Dog Boarding Registration Form Owner Information Your name Dog s Name Address Home Phone Cell Phone Email: please send me email updates on my pet please DO NOT send me email updates on my pet Emergency Contact Name: Relationship Home Phone Work Phone Cell Phone

Veterinarian Information Name: phone number Vet Clinic/Practice Name Does anyone besides you (the owner) have the authority to pick up your pet from his/her boarding stay? Yes No If so: Name Relationship Pet Information Name Breed Age Sex Approx. Weight Sprayed/Neutered Y N Color Micro-chipped Y N Number Where did you get your dog: When did you get your dog: If you adopted your dog, do you know anything about their history: Is your dog a jumper, climber or escape artist? Y N if yes, please explain Is your dog a barker? Y N if yes, please explain Does your dog have any food allergies? Y N if yes please explain Physical Limitations medical problems your dog has: Is your dog on any medications? Y N If yes, please lists: Does your dog have any current injuries or incision/sutures stapes? Y N

If yes, please describe date, location and reason: We perform daily body checks on our dogs. Are there any lumps, warts or growths we should be aware of? Has your dog coughed, sneezed, wheezed or exhibited any asthmatic symptoms recently? Y N if yes please explain Is your dog frightened of any types of noise or action? Has your dog every been toy aggressive towards other dogs or humans? Has your dog ever bitten another dog or person? Has your dog every growled at another dog or person? What commands does your dog respond to: (sit, stay, off, etc) Is there anything else we should know about your pet? I certify that the information provided in this Registration Form is true and Rex s Place Boarding House can rely on the accuracy of this information:

- - Owner Signature Date Printed name