BARKING LOT RESERVATION FORM

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Barking Lot Bldg. 1052 DSN: 253-3588 Int.: 011 81 82 779 358 BARKING LOT RESERVATION FORM Owner s Name: Check-In AM PM Check-Out AM PM 1.) This reservation is for PCS Regular 2.) Is this reservation for quarantine requirements? Yes No If Yes, what is the quarantine end date? 3.) Is your animal aggressive towards other animals? Yes No 4.) Is your animal aggressive towards humans? Yes No 5.) Does your animal utilize pee pads? Yes No If Yes, please provide for the duration of their stay. Pet Name: Feeding Instructions (how much in cups, how often a day, etc.): Special Instructions (behavioral information, special considerations, requests, etc.): _ Pet Name: Feeding Instructions (how much in cups, how often a day, etc.): Special Instructions (behavioral information, special considerations, requests, etc.): _ Official Reservation Form Effective 2018

Emergency Contact. Please provide at least one emergency point of contact. Individual must be over eighteen (18) years of age, have access to installation, be in the local area for the duration of your leave, and cannot be your spouse. In appointing an emergency contact, you are authorizing that individual to make decisions regarding the care and disposition of your pet. The emergency contact must administer medication, be present for any veterinary appointments, and is responsible for any charges incurred. 1.) Name of Emergency Contact: Phone Number: Alt. Phone number: Email Address: Unit: Work Phone number: Rotation I agree to indemnify, waive, release, and forever discharge the U.S. Marine Corps, the Marine Corps Community Service, the NAF Business and Support Services Division, and any other individuals or entities connected in any way with the boarding of my animal(s) from any and all claims for damages, death, personal injury or property damage and litigation costs/attorneys fees, arising from or contributed to, in whole or in part, by any act, omission, fault or mistake of the abovenamed persons or entities and their employees or agents, resulting from the boarding of my animal(s). This waiver and release shall be binding on my heirs and assigns and shall run in favor of the abovenamed persons or entities and any individuals in any way connected with the aforementioned event. By signing below, I affirm that I have understood and accept all terms and conditions of Barking Lot Agreement. Accepted by Barking Lot Staff: Official Reservation Form Effective 2018

Barking Lot Bldg. 1052 DSN: 253-3588 Int.: 011-81-82-779-3588 BARKING LOT BOARDING AGREEMENT Owner s Name: Owner s Spouse Name: Email Address: Phone number: Unit: Alt. Phone number: Work Phone number: Rotation Pet Name: Breed: Gender: M F Age: Weight: Please tell us about your pet (behavioral information, special considerations, allergies, requests, etc.): Pet Name: Breed: Gender: M F Age: Weight: Please tell us about your pet (behavioral information, special considerations, allergies, requests, etc.):

Owner Name: Pet(s) Name: Boarding is limited to dogs and cats. Pit bulls, Rottweilers, mixed breed Pit bulls/rottweilers, canine/wolf hybrids Dogs determined to be dangerous, in accordance with MCO P11000.22 Ch. 6, may not be boarded. I understand that boarding my animal is not without risk and understand: 1. A deposit equal to 1 day of boarding is required to hold the reservation. If I cancel or change my dates I must give 24 hours notice to qualify for a full refund. If I pick up my animal prior to my reservation end date without 24 hours notice the day of pickup will be charged as a full day of boarding. If you paid by credit card, then the refund can be put back onto the card used. Cancellations with less than 24 hours notice will also result in loss of deposit. All refunds must be claimed within 30 days of cancellation. 2. Full payment must be made the day the pet(s) are brought for boarding. If you have PCS d in and need to extend due to non-availability of housing and the kennels have space available, payment for services will need to be paid every two weeks until your pets have been picked up. Cash and all major credit cards are acceptable forms of payment. Requests for partial payment must be reviewed by the Chief of Retail & Services or his/her designee. 3. After hour's drop-off/pick up of pets must be pre-arranged two weeks in advance unless due to Patriot delay. The late drop-off time as 5:00 p.m. - 10:00 p.m. Early pick-up time (7:00 a.m. - 9:00 a.m.) is allowed ONLY for PCS OUT of Iwakuni. 4. The kennels takes appropriate measures to prevent theft and ensure the safety and health of my animal. If my animal is stolen or escapes, the kennel will only reimburse boarding fees (deposit) and a one- time compensation fee not to exceed $100.00. If I desire more than the above stated amount, I must make arrangements for private insurance. 5. Owners can bring their own blankets or toys if desired, however we cannot guarantee that they will be returned in the same condition or at all. We provide bedding, therefore we ask that you please leave those at home unless you feel it is critical to your pet s stay. The kennel will not be held responsible for items lost/left at the facility. I understand that any items left behind will be disposed of after one (1) week of picking up my pet(s).

6. For all non PCS customers the pet must have a current Rabies (annually) and Distemper (annually or 3yr annotated), Kennel Cough (annually for dogs & only provided by the Iwakuni VTF) vaccination prior to boarding. A reservation is not confirmed until vaccinations are up to date, or proof that an appointment with the Veterinary Treatment Facility has been made to receive vaccinations prior to boarding, and a pre-board payment has been made. It is my responsibility that I prepare the vaccination agreement for my animal. In the event I am not able to meet the vaccination requirements I will still be responsible for kennel boarding fees of original reservation. For PCS in, current print out from the vet clinic of services done with Pet s name will be sufficient. 7. In an emergency or natural disaster, every effort will be made to contact you or your emergency contact to retrieve your pet. You agree that MCCS Barking Lot, at its sole discretion, is authorized to transport, and/or to make temporary alternative arrangements to house and care for your pet until you or your emergency contact can retrieve your pet. You understand that it may not always be possible to safely evacuate your pet. YOU RELEASE MCCCS BARKING LOT, U.S. MARINE CORPS AND ITS AFFILIATES FROM ANY LIABILITY OF DEATH OR INJURY DUE TO EMERGENCY OR NATURAL DISASTER. 8. Please be aware that some animals do experience stress-related illness, and boarding may cause their chronic conditions to worsen during their stay. If my animal becomes ill and/or requires medical attention, I (the Owner) will be liable for all costs incurred, to include charges by an off base veterinarian or an emergency military veterinarian, administration of medications (oral or topical), and any other medically authorized treatments (i.e. baths). I authorize the kennel personnel contact my emergency point of contact to take my animal to the clinic for treatment. 9. All pets boarding at Barking Lot must be on a flea and tick preventive. The Kennels will not be responsible for fleas and ticks on your pet. 10. If you are boarding more than one pet and the pets are not getting along, neither of the pets are fixed, a medical condition has forced the pets to be separated to prevent further complications, or the female is in heat the Kennel personnel will separate the pets and you will be charged for separate kennels. If boarding more than one pet and they are too small and need to be housed in a Kennel within a kennel, additional fees may be incurred due to not being able to stack more than one kennel in a run. 11. I understand that I am solely responsible for any harm or damage caused by my pet(s) to persons, any other pets housed or visiting, or property of the owners while my pet(s) is/are staying at the kennels.

12. I must supply adequate food for the duration of the stay. If the supply of food becomes inadequate the kennels will call the Emergency contact to bring food in for your pet. If they cannot bring in food, it will be supplied at rate of $3.00 per day per pet and I will be liable for the cost. We do NOT serve raw food in our facility. 13. I must notify the kennels prior to the date of scheduled pick up if my animal needs to be boarded for a longer period than expected. Extension of boarding without notification will result in additional fees equal to 1 day of boarding on top of the daily boarding fee per day per pet. 14. If my animal soils himself/herself or gets muddy, a kennel bath will be administered at the discretion of the Barking Lot, and my account will be charged for the additional fees. Please understand that your pet may soil themselves after grooming but prior to their pick up. 15. I understand that if my pet has had surgery within two weeks prior to boarding, I can be denied boarding with a loss of my deposit. Barking Lot is not equipped as an after care facility and will not be responsible for any problems that may result from surgery when boarding. We will require that the pet be healed and cleared from a vet before they can be boarded. 16. Pets requiring ongoing medication must be medicated by the Emergency Contact. It is the owner s responsibility to inform and provide all medications and medical requirements to the Emergency Contact. 17. My pet(s) must be picked up by 5:00pm on the day of pick up. Any time after this will incur additional boarding and/or after hour fees. I understand the hours of operation, and that early pick up and/or late drop off charges may occur outside of normal business hours. 18. I understand it is my responsibility to notify the Barking Lot of any changes to my information or my emergency point of contact(s) information immediately.

I agree to indemnify, waive, release, and forever discharge the U.S. Marine Corps, the Marine Corps Community Service, the NAF Business and Support Services Division, and any other individuals or entities connected in any way with the boarding of my animal(s) from any and all claims for damages, death, personal injury or property damage and litigation costs/attorneys fees, arising from or contributed to, in whole or in part, by any act, omission, fault or mistake of the abovenamed persons or entities and their employees or agents, resulting from the boarding of my animal(s). This waiver and release shall be binding on my heirs and assigns and shall run in favor of the abovenamed persons or entities and any individuals in any way connected with the aforementioned event. By signing below, I affirm that I have read and accept all terms and conditions of this Agreement. Accepted by Barking Lot Staff: