Camper's Name*Owner's Name* First Last Owner's Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Animal Camp agrees to exercise, give reasonable care and keep the kennel premises sanitary. Your pet will be fed properly and regularly according to the schedule you give us. Your pet will be housed in clean, safe quarters. All pets boarded or otherwise handled or cared for by employees of Animal Camp, Inc., with out liability on our part for loss or damage from disease, death, running away, theft, fire, injury to persons, other dogs , or property by said pet, or other unavoidable causes. By signing this contract you hereby entrust Animal Camp, Inc., to care for your pet during any stay at the kennel and agree to all of the listed below. I authorize Animal camp, Inc. to do whatever they deem necessary for the health and well being of my pet and agree to pay any and all expenses relating to same. If my pet requires the attention of a Veterinarian while under the care of Animal Camp, Inc., it will be administered by an available Veterinarian. I agree to have my pet arrives at Animal Camp, Inc. with updated vaccination (for dogs: Rabies, distemper and Bordetella) and (for cats: Rabies, feline distemper and feline leukemia). I will bring proof from my Veterinarian or have them fax a copy over to Animal Camp. Fax # 1-734-433-1444. I understand that if my pet(s) are not vaccinated, Animal Camp can refuse boarding of my pet. If my pets arrives at Animal Camp, Inc. and fleas/ticks are found in the first day, a bath and flea dip will be given and a charge for doing so will be added to the bill or possible be sent back home. I agree to pay daily board at Animal Camp, Inc. posted rates. If my pet requires special care (for geriatrics, etc.) I authorize Animal Camp to provide that care and agree to pay for all those services. I agree to pay for any auxiliary services, products, requested by me such as transportation, grooming, food, etc. I agree that I am solely responsible for any damages that the above-mentioned pet may cause through malicious or improper conduct. I have read this agreement on this date,* Date Format: MM slash DD slash YYYY ...understood its terms and signed it freely. This contract is to be considered valid for any visit after this date. Owner or Owner's Representative Signature*Kennel Representative SignatureOwner's Emergency Phone*Owner's Cell Phone*Who can we contact locally in case of emergency?* First Last Emergency Phone*Emergency Cell*Animal Camp, Inc. Emergency Treatment Waiver While rare, if in the event of an emergency and/or life-threatening or major problem concerning your beloved pet, I need to know your wishes. In this event, I will be trying to reach you and notify you of the situation so that you can make your own decisions. However, if I can not reach you in a timely manner and decisions must be made by me and/or the veterinarian who is treating your pet, these guidelines will be followed to the best of my/our abilities. Sometimes a procedure is expensive and/or of poor prognosis and/or prone to complications. If your pet needs extra-ordinary medical measures (anything other than "routine" care, i.e. vaccinations, heartworm, worm medicine, minor veterinary care) what would you like us to do? All Fees for medical care are the responsibility of the owner and must be settled with the veterinarian in question or paid directly to me if I have already paid the vet.Use the treating veterinarian's discretion as to treat vs. euthanize?*Please SelectYesNoFinancial Limitations?*Please SelectYesNoSpending LimitIf euthanization is required, please authorize, vet. handles body cremation.Veterinarian to Contact*Your signature indicates anesthesia permission if it is required in the treatment/diagnosis of your pet. If your feelings about any of these matters change from what is recorded here, it is your responsibility to notify Animal Camp, Inc. prior to leaving your pet at any given visit! Signature*Date* Date Format: MM slash DD slash YYYY This iframe contains the logic required to handle Ajax powered Gravity Forms.