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SPOT for Dogs, LLC REGISTRATION AND RELEASE Owners Information Name: _____________________________________ Address: ___________________________________ City, State,

Zip: ______________________________ Home Telephone #: __________________________ Cell Phone #: _____________ Business Phone #: _________________________ Email Address:_______________________________ Your Dogs Information Dogs Name: _______________________________ Birthday (best guess, month/year): _____________ Sex: Altered?: _____ (all dogs must be altered by 6 months of age) Breed (best guess): __________________________ Weight: _______ Color(s): ______ Your Dogs Personality Has your dog ever been: [ ] Around other dogs [ ] To Dog Daycare How is your: Dogs behavior with people: [ ] Fearful [ ] Aggressive [ ] Other Please Explain: Dogs behavior with other dogs: [ ] Fearful [ ] Aggressive [ ] Other Please Explain: Has your dog ever bitten another dog or a human? [ ] No [ ] Yes Please Explain: Vet. Office:___________________________ Vet. Phone:___________________________ Vet. Address:__________________________ Is your dog current on: Rabies, DHLPP, and Bordatella?: _________ (You must provide a copy from your vet. office) Heartworm Medication?: _________________ Flea and Tick Medication?: ______________ (We reserve the right to inspect for fleas and to refuse admittance to flea-carrying dogs) [ ] To the Dog Park [ ] None Todays Date:

How Did You Hear About Us?: ___________ ____________________________________ ____________________________________ ____________________________________

[ ] Dominant

[ ] Submissive

[ ] Dominant

[ ] Submissive

Please list any known food allergies: ___________________________________________________________________________________ ___________________________________________________________________________________ Describe any known health conditions, medications, or concerns: ___________________________________ __________ 24 Hour Care (Boarding Dogs Only) We ask that you supply us with your own dog food in order to maintain your dogs normal diet. If you choose not to, we will serve your dog our house food for $2 a meal. In addition, you are encouraged to bring anything that will help your dog feel more at home (toys, bedding, etc.). Food Brand and Instructions: Breakfast: _________Lunch:_________

Dinner:

_____________

SPOT for Dogs, LLC reserves the right to change your dogs level or type of boarding/daycare immediately if we believe it is necessary to protect the health and well being of your dog, other dogs, or employees. SPOT for Dogs, LLC cannot guarantee toys, blankets, or beds will be returned in the same condition as delivered to us. All dogs over 6 months old must be spayed or neutered and must have all vaccinations. We require proof of these vaccinations. Dogs must not have been exposed to any illness within a 30 day period prior to a visit at SPOT for Dogs, LLC. Owner agrees to notify SPOT for Dogs, LLC of any exposure to any virus, infection or other transferable illness and will not bring dog to SPOT for Dogs, LLC until dog is symptomfree for a reasonable period to be determined by dogs veterinarian or until written approval is obtained from a veterinarian. Owner further agrees not to bring dog to SPOT for Dogs, LLC if dog is exhibiting any signs of illness that may be harmful to the other dogs in attendance, such as vomiting, diarrhea, extreme lethargy, etc., without first obtaining approval from SPOT for Dogs, LLC. Changing a dogs food can cause severe upset stomach. SPOT for Dogs, LLC recommends you bring your own food. There is a $2 per day charge for feeding your dog our house food should you not provide your own food. Dog Owner understands the risks involved with communal boarding of dogs. Our boarding and daycare dogs play inside and outside with other dogs. Although we offer reasonable care, the unpredictable personality of dogs can sometimes lead to injury or spreading of illnesses, such as Kennel Cough. Dog Owner expressly agrees that SPOT for Dogs, LLC liability for any circumstances related to the dog shall in no event exceed the current chattel value of a dog of the same breed, without regard to parentage or pedigree, as the dog delivered by Owner to the facility pursuant to this contract. Owner represents to SPOT for Dogs, LLC that all credit card information Owner has provided is accurate. Owner further represents that all information he/she has provided to SPOT for Dogs, LLC is accurate, and that he/she is over 21 years of age. SPOT for Dogs, LLC reserves the right, without notice, to adjust its fees for services. Please inquire at the front desk as to our current fees. Our policy regarding BOARDING charges is as follows: A boarding charge applies when a dog stays in our facility for a 24-hour period. On your check out day, a four-hour grace period will be allowed after your pick up time. Owners of dogs picked up after this four-hour window will be charged for a day of daycare. Upon a dogs departure, a daycare charge is added only when the dogs checkout time is more than four hours after his check in time. Owner agrees that if dog becomes ill or if the state of the dogs health otherwise requires professional attention, SPOT for Dogs, LLC, in its sole discretion, may engage the services of a veterinarian of our selection or administer medicine or give other requisite attention to the dog, and the expenses thereof shall be paid by the Owner. Owner gives consent to SPOT for Dogs, LLC to act in the Owners behalf in obtaining emergency veterinary care at Owners expense if deemed necessary by SPOT for Dogs, LLC or any of its emplo yees, officers, directors, agents, etc. Owner agrees to indemnify and hold SPOT for Dogs, LLC, its owners, members, managers, and employees harmless from: The expenses associated with such veterinarian care and treatment; and, the acts or omissions of any licensed veterinarian so engaged to provide services to Owners dogs. Owner agrees to pay all charges for special services requested, all veterinary costs for dog during the time said dog is in the care of SPOT for Dogs, LLC (including transportation to/from the veterinarian clinic), and all fees incurred by Owner through Owners failure to comply with SPOT for Dogs cancellation policy. Owner agrees to pay the rate for day care and/or boarding in effect on the date Owner checks dog into SPOT for Dogs, LLC. Owner hereby grants SPOT for Dogs, LLC a lien on owners dog for any and all unpaid charge resulting from daycare, boarding, or any other service provided by SPOT for Dogs, LLC. Owner assumes any and all expenses or liability for injuries that Own ers dog may inflict on any human or other dog while in the facility. Owner agrees to indemnify and hold SPOT for Dogs, LLC and its employees harmless from any and all expenses and liability incurred as a result of injuries Owners dog inflicts upon any human or other dog while in the facility. All dogs must have an identification tag with either a phone number or address of the Owner. We recommend the tag include th e dogs name. All dogs must be on a leash when entering or leaving the premises. By signing below, I understand and agree to abide by any and all policies outlined in this agreement; and, that this Agreement constitutes the sole and entire agreement between us concerning your dog. This agreement shall be governed by Georgia law.

Signature:__________________________________________

Date:____________________