House of Hounds Enrollment Application

Personal Information  
Name: (first and last)
Address:
City
State:
Zip:
Home Phone: (123-456-7890)
Work Phone:
Cell Phone:
Can we text appointment reminders to your cell phone number listed above?  
Other Phone:
Your Email: (we do not share your email with any 3rd party, only for confirmation of appointments and specials we are running)
   
Dog Information  
Name:
Breed:
Weight: (lbs.)
Color:
Age:
Birthday: (01/23/45)
Sex:
Spayed/Neutered:
Brand of food:
Canned or Dry:
Times fed per day:
   
Emergency Contact Info.  
Name:
Home Phone: (123-456-7890)
Work Phone:
Cell Phone:
Other Phone:
List of persons that can pick up your dog other than above:
In order to secure your pets safety while in our care, we require a "safe" word for anyone picking up your pet besides you. Your "Safe Word" is:
How did you hear about us:
   
Veterinary Information (if available)
Name:
City:
State: (WV)
Zip:
Phone Number: (123-456-7890)
   
Dog Profile  
Does your do have any medical conditions such as seizures or any type of disorder or allergies we should be aware of:
If yes please explain:
Does your dog get upset during thunderstorms:
Can your dog jump or climb a six foot chain link fence:
What form of flea & heartworm preventive do you use:
How much exercise or activity is your do used to on a daily basis:
Is your dog permitted to have table food:
Please describe any tricks or commands your dog knows:
Describe your dogs temperament:
Where in your home does your dog sleep at night:
Does your dog have any bad habits we should be aware of:
If yes please explain:
Does your dog have a history of biting humans or animals:
If yes to either please explain:
Has your dog ever growled or snapped at anyone who has touched his/her food or toys:
Do we have permission to take your dog(s) for field trips or leash walks off the House of Hounds premises:
Please list any special instructions for your dog:
   

HOUSE OF HOUNDS CLIENT AGREEMENT
THIS IS A CONTRACT BETWEEN “HOUSE OF HOUNDS” AND PET OWNER(S)

  1. OWNER AGREES TO PAY THE RATE $30.00-$50.00 PER NIGHT BOARDING BASED ON WEIGHT, GROOMING, AND DAYCARE ON THE DATE AND TIME THE PET IS PICKED UP FROM HOUSE OF HOUNDS.
     
  2. OWNER FURTHER AGREES TO PAY ALL COSTS AND CHARGES FOR ANY AND ALL SERVICES NEEDED OR REQUESTED, INCLUDING, BUT NOT LIMITED TO, ANY AND ALL VETERINARY COSTS FOR THE PET DURING THE TIME THE PET IS IN OUR CARE, AND ANY VETERINARY COSTS INCURRED DUE TO THE PET’S STAY. OWNER FURTHER AGREES THAT THE PET SHALL NOT LEAVE THE PREMISES UNTIL ALL CHARGES INCURRED ARE PAID TO HOUSE OF HOUNDS.
     
  3. BY SIGNING THIS CONTRACT AND LEAVING YOUR PET WITH HOUSE OF HOUNDS, OWNER CERTIFIES TO THE ACCURACY OF ALL INFORMATION GIVEN ABOUT SAID PET.
     
  4. IT IS EXPRESSLY AGREED BY THE OWNER AND HOUSE OF HOUNDS THAT HOUSE OF HOUNDS LIABILITY SHALL IN NO EVENT EXCEED THE LESSER OF CURRENT CHATTEL VALUE OF A PET OF THE SAME BREED OR SPECIES OR THE SUM OF $200.00 (TWO HUNDRED) PER ANIMAL. THE OWNER FURTHER AGREES TO BE SOLELY RESPONSIBLE FOR ANY AND ALL ACTS OR BEHAVIOR OF SAID PET WHILE IN THE CARE OF HOUSE OF HOUNDS.
     
  5. OWNER SPECIFICALLY REPRESENTS THAT HE OR SHE IS THE SOLE OWNER OF THE PET, FREE OF ALL LIENS AND ENCUMBRANCES.
     
  6. OWNER SPECIFICALLY REPRESENTS TO HOUSE OF HOUNDS THE PET HAS NOT BEEN EXPOSED TO RABIES OR DISTEMPER WITHIN A THIRTY DAY PERIOD PRIOR TO ANY STAY.
     
  7. I AGREE, IF MY PET SHOWS ANY SIGNS OF FLEAS OR TICKS DURING ITS STAY, THAT HOUSE OF HOUNDS MAY BATHE MY PET AND I WILL BE CHARGED ACCORDINGLY (SEE GROOMING PRICES).
     
  8. IF PET BECOMES ILL OR IF STATE OF THE ANIMAL’S HEALTH OTHERWISE REQUIRES PROFESSIONAL ATTENTION, HOUSE OF HOUNDS, IN ITS SOLE DISCRETION, MAY ENGAGE THE SERVICES OF A LOCAL VETERINARIAN OR PROVIDE APPROPRIATE MEDICAL ATTENTION TO THE ANIMAL AND ANY AND ALL EXPENSES THEREOF SHALL BE PAID BY THE OWNER. IN THE EVENT OF A MEDICAL EMERGENCY, DUE TO LOCATION OF THE PRIMARY VETERINARIAN OR THE TIME OF DAY DURING THE EMERGENCY, HOUSE OF HOUNDS RESERVES THE RIGHT TO TAKE YOUR PET TO THE NEAREST VETERINARIAN.
     
  9. THIS CONTRACT CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES. ALL TERMS AND CONDITIONS OF THIS CONTRACT SHALL BE BINDING ON THE HEIRS, ADMINISTRATORS, PERSONAL REPRESENTATIVES AND ASSIGNS OF THE OWNER AND HOUSE OF HOUNDS.
     
  10. I UNDERSTAND THAT DURING ANY AND ALL HOLIDAYS MY DEPOSIT FOR BOARDING IS NON-REFUNDABLE AND CAN ONLY BE USED AS A CREDIT TOWARD FUTURE BOARDING, DAYCARE, AND/OR GROOMING.

I HAVE READ, UNDERSTAND, AND AGREE TO ITEMS 1-10. OWNER'S INITIALS:


 

I, MY HEIRS AND ANY ASSIGNS HEREBY RELEASE HOUSE OF HOUNDS, ITS AGENTS, OFFICERS, SUBCONTRACTORS, EMPLOYEES, ANIMAL OWNERS, CUSTOMERS AND POTENTIAL CUSTOMERS OF HOUSE OF HOUNDS FROM ANY AND ALL LIABILITIES FOR INJURIES TO MYSELF, MY PET OR ANY OTHER PROPERTIES OF MINE WHICH ARISE IN ANY WAY OUT OF SERVICES AND/OR PRODUCTS PROVIDED BY OR AS A CONSEQUENCE OF MY ASSOCIATION WITH HOUSE OF HOUNDS. I ACKNOWLEDGE AND UNDERSTAND THAT EVERY PET REACTS DIFFERENTLY AND THAT ANIMALS, BY NATURE, ARE UNPREDICTABLE. DOGS MAY, WITHOUT WARNING, BITE OR CAUSE INJURY TO HUMANS AND OTHER PETS. I ACKNOWLEDGE AND UNDERSTAND THAT THERE ARE CERTAIN RISKS INVOLVED IN PET OWNERSHIP, TRAINING AND CARE, INCLUDING, BUT NOT LIMITED TO, DOG FIGHTS, AND DOG BITES TO HUMANS AND/OR OTHER PETS AND THE TRANSMISSION OF DISEASE. WITH MY SIGNATURE BELOW, I UNDERSTAND THE RISK INVOLVED IN PUTTING MY DOG IN A CAGELESS ENVIRONMENT AND ACKNOWLEDGE AND ACCEPT EXCLUSIVE AND SOLE RESPONSIBILITY FOR ALL MEDICAL EXPENSES TO MY PET NO MATTER THE CAUSE. I ALSO AUTHORIZE THE RELEASE OF SAID PET’S MEDICAL RECORDS FROM MY VETERINARIAN. I HAVE READ, UNDERSTAND, AND AGREE TO ITEMS ON PAGE 3 AND PAGE 4 OF THE HOUSE OF HOUNDS CLIENT AGREEMENT.

Digital signature (type your full name and the date below to agree to and sign this document):
 Name:   Date: