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Last Name: 1691 Highway 357 Lyman SC, 29365 Phone: (864)655-5884 Fax: (864)655-5812 Support@theultimatepetlodge.com Client Contract Form Owner Information First Name: Address: City: State: Zip Code: Home Phone: Work Phone: Cellular Phone: Email: Please provide your cell phone provider for conformations: Cell Phone Provider: Emergency Contact: Phone: How did you hear about our Lodge? Date to check in: AM/PM Date to check out: AM/PM Dog Information Name of Dog: Date of Birth: Breed: Color: Weight: Male Neutered: Yes No Female Spayed: Yes No Microchip Number: Microchip Manufacturer: If your dog is NOT spayed/neutered over the age of 7 months, it will not be allowed in group dog daycare and will have individual play time only. Initial: Does your dog play well with other dogs? Dog profile Yes No Does your dog act afraid of any specific items or noises? Has your dog ever bitten anyone? Yes No If yes, what were the circumstances? Is your dog protective over food, toys, and/or other objects? Yes No If yes, please explain: Does your dog have any fears or dislikes? If so, explain: Any history of destructive chewing? Yes No If yes, please explain: Can your dog climb or jump a fence? Yes No Separation Anxiety? Yes No

Veterinarian Information Clinic Name: Phone: Address: City: State: Zip: Required Vaccines : Please attach vaccine records to contract Vaccine Date Given Date Due Rabies Distemper/Parvo Bordetella Canine Influenza (Recommended) Fecal Test *All dogs entering The Ultimate Pet Lodge must have up-to-date vaccinations that have been administered by a licensed veterinarian. Dogs must be 12 weeks old and have a minimum of 2 rounds of vaccinations and a Bordetella. Prior to check in, canine guest must submit written proof of DHPP, Rabies, 1 or 3 years; Fecal test; Bordetella 6 months or yearly vaccine. Dogs must have received inoculations at least 5 days before entering the lodge. It is the owner responsibility to provide current shot records to The Ultimate Pet Lodge before any boarding or services are rendered. All pets are required to be vaccinated, however it is still possible for a pet to become ill even if vaccinated. The Ultimate Pet Lodge LLC is not responsible for any veterinary expenses your pet(s) becomes ill. Initial: Describe any medical conditions, surgeries or physical impairments and/or any physical limitations to be aware of before your dog participates in any activity? Arthritis Diabetes Allergies Ear/eye infections Hot Spots Ligament/tendon issue Stress-related Diarrhea (colitis) Seizures Yes No If yes, How often? Medications 1.) 2.) 3.) Name Dosage/Instructions All medications must be in their original vials with a legible prescription label from their vet. Feeding (Please bring his/her food pre-measured in Ziploc bags labeled with his/her name for am and pm) Brand of food (dry and/or can): How much per feeding: Breakfast: Lunch: Dinner: Treats or special foods added: Does your dog have any food allergies? Yes No If so, please explain: Page 2

Boarding Pricing Boarding prices are all inclusive of playtime, walks, administration of medicine and owner or house treats and food. If boarding 5 nights or longer a complementary basic exit bath included with stay. If your dog or dogs do not get along with others they will have individual playtime in yards when group play is not in session. Boarding Pricing: $40 Per night for first or single family dog $30 Per night for each additional dog in same suite $35 Per night for first additional dog in separate suite Boarding Extended Stay Pricing: 10% discount for a 9-night stay or longer 15% discount for a 20-night stay or longer Boarding Packages: (no expiration date on packages) 10 Day Single Dog Boarding Package $360 10 Day Double Dog Family Boarding Package $630 Daycare Pricing The Ultimate Pet Lodge is committed to providing a safe, fun, and stimulating social environment for your dog Monday through Saturday. At daycare your pet will enjoy supervised playtime with other dogs and our friendly staff. You may also bring your dog a snack and treats for them to enjoy during rest time. 7:00 a.m. 8:30 a.m. Drop off time for daycare and grooming dogs 9:00 a.m. 12:00 p.m. Morning play session 12:00 p.m. 2:00 p.m. Rest time for lunch and snacks in suites 2:00 p.m. 6:00 p.m. Afternoon play session and pick up Daycare Pricing: $20 Per dog for all day play $12 Per dog for half day play (Morning Session 7am-1pm or Afternoon Session 1pm-6pm) Daycare Packages: 10 Day daycare package $180 20 Day daycare package $340 Page 3

Boarding and Daycare Hours (There is no Group Play on Sunday, it is a day of rest for the dogs) Monday thru Friday 7:00 am to 6:00 pm Saturday 7:00 am to 4:00 pm Sunday 3:00 pm to 6:00 pm Daycare: Closed to the public on Sunday, and Holiday Weekends Boarding: Closed to public on Easter Sunday, July 4 th, Labor Day, Thanksgiving Day, Christmas Day, and New Year s Day. Please remember just because we are not open to the public on these days, our staff is still here taking care of your pets Training Pricing Would you like for your dog to have training while boarding or daycare? Yes No Training will be on Tuesdays during lunch/rest time from 12:00 p.m. 2:00 p.m. while boarding or daycare. They are one on one private thirty-minute sessions with our trainer. Training is an additional $30 per session plus daycare price Grooming Services Would you like your dog to have any grooming services during his/her stay? Yes No If so, What service? (Dogs receive complimentary free bath after 5 days) Complementary Bath Bath Groom Nails *If your dog is receiving a complementary bath or grooming service, you must allow 24 hours notice of change in reservation or services may not be rendered. * Weight Bath(Short Hair) Bath(Long Hair) Groom Nails Small (up to 20 Ibs) $20 and up $25 and up $40 and up $8 Medium (21-40 lbs) $30 and up $35 and up $45 and up $10 Large (41-60 lbs) $35 and up $45 and up $65 and up $15 X-Large (61-80 lbs) $40 and up $50 and up $75 and up $15 XX-Large (81 lbs and up) $45 and up $55 and up $85 and up $15 (Please remember all prices are estimates depending on the condition and length of the dog s coat) Page 4 Bath Includes: Nail trim and dremel; Ear Cleaning and plucking; standard hypo-allergenic shampoo, anal gland expression. Blow dry and brush; bandana or bows, fragrance spritz, sanitary clip and paw pads Groom includes all elements of the bath, plus full body trim or shave

Rules and Regulations Flea, Tick, and Intestinal Parasites: All dogs must be flea and tick free before entering the lodge and will be inspected before their stay. Dogs will not be allowed in group play if they have fleas and/or ticks and will be given a flea bath at owner s expense. If your pet is found to harbor intestinal parasites during his/her stay The Ultimate Pet Lodge has the right to get veterinary service for de-worming at owner s expense. Health and Special Needs: All dogs must be in good health. The Ultimate Pet Lodge has all rights to limit group play for the older or physically limited dogs if we feel it is in their best interest. Behavior: Boarding: We will NOT accept dogs who signs of aggression towards people or destructive to our suites. Daycare: All dogs must be non-aggressive towards people and other dogs; must pass temperament evaluation. Owners will need to certify that their dog(s) has not harmed or shown any aggressive or threatening behavior towards any person or any other dogs. Any behavior deemed dangerous or inappropriate by The Ultimate Pet Lodge might result in dismissal from group play. Please remember your dog will be spending time with other dogs and the safety and health of all pets are our prime concern. Beauty Maintenance: Dogs playing during daycare or boarding guests participating in group play can get dirty and those with long hair can get matted. Scheduled baths and brush-outs are available upon request and specific charges will apply to these services. Food: Included in our rates, Nature s Select is served to our guests. Keep in mind changing your dog s diet may cause problems as in not eating, upset stomach, diarrhea, and/or colitis. We recommend you bring your own food for your dog(s) benefits, please package the food in zip lock bags labeled with the pet s name and amount. Pets Possessions: You are welcome to bring your dog s treats, toys, and your pets favorite bedding. We are not responsible for lost or left or destroyed possessions during your dogs stay. Cancelations: In case of a no show all deposits will be automatically forfeited. A 1-week cancelation notice is required during Holidays and Spring Break. If cancelation is not made before that time, then all deposit s will be forfeited. Payments: The Ultimate Pet Lodge accepts Checks, cash, debit or credit cards. Payment is due on the day of pick-up and a deposit upon reservation may be required with new clients. Emergencies: While your dog is under the care of The Ultimate Pet Lodge we will use all reasonable precautions against injury and escape. Please be aware that some pets are under stress while away from their owners and may become ill during boarding and/or while participating group activities. Furthermore, when pets are around people or other dogs, unforeseen, unavoidable or unprovoked accidents or injuries may result and dogs, people and property may be injured or damaged. Page 5

Abandoned Pet Procedure: If for any reason the animal is not going to be picked up on the scheduled dismissal date, Owner shall contact The Ultimate Pet Lodge to make arrangements to extend the animal's stay and will pay the additional charges based upon the said nightly rate. If you fail to pick up your pet by the designated time we will attempt to contact you by telephone and/or writing using the information that you have provided, advising that if your pet is not picked up within a reasonable time period that your pet will be deemed to be abandoned and will become property of The Ultimate Pet Lodge. You understand you will lose ownership of your pet under these circumstances. You shall remain liable to us for all unpaid Charges, including without limit the court costs and reasonable attorneys' fees incurred in the collection of the Charges. Initial: In the event that my pet(s) becomes ill, (including but not limited to diarrhea, vomiting, ear infections as well as emergency illness) and/or is injured during a visit or stay at The Ultimate Pet Lodge LLC and all reasonable means to reach me or my authorized agents have failed, I hereby authorize any emergency treatment and or administration or medication deemed necessary by the pet(s) veterinarian. I consent to the administration of anesthesia or sedation and/or x-rays as deemed necessary by doctors and agree to pay or all such treatment(s) and all emergency care. I accept that all fees incurred for the treatment of my pet(s), that the facility my pet(s) have been transported to, to be my responsibility therefore releasing The Ultimate Pet Lodge of any financial responsibility with them. Owners Signature: By opting to use The Ultimate Pet Lodge and thereby accepting its Rules and Regulations, I hereby release The Ultimate Pet Lodge and its owners, employees, successors, assigns and all affiliated parties from any and all liability, claims, demands, causes of action, loss, damage, including any death and serious injury which may result I (owner), my pet(s) or my guest(s) are on the premises of or attending any event sponsored by The Ultimate Pet Lodge LLC. I agree to pay for the reasonable cost of collection, attorney fees, and court costs in the event that collection efforts become necessary and I agree that the venue of the action will be in the county where the lodge is located. I also agree to be responsible for any liability caused by me (owner), my pet(s) and my guests, and that I will hold harmless and indemnify The Ultimate Pet Lodge LLC and its owners, employees, successor, assigns and all affiliated parties from any liability, claims, demands, causes of action, loss, damage, or injury to person or property, including any death and serious injury which may be caused by myself (owner), my pets or my guests while they are on the premises of or attending any event sponsored by The Ultimate Pet Lodge LLC. I have read, understand and agree to comply with The Ultimate Pet Lodge LLC. Signature Print Name Date Page 6