Day Care And Boarding Enrolment Forms (Page 3 of 4) in pdf

Day Care And Boarding Enrolment Forms Page 3

Employer:

(if owner(s) cannot be reached)

Emergency Contact:

Name:

Phone:

Relation to family:

Email:

Veterinarian:

Veterinarian Name:

Hospital Name:

City & State:

I understand that in the event of an emergency, Learning

Pawsibilities will make every attempt to contact me. In the

event that I cannot be reached, I authorize the following:

In the event of illness or injury, I authorize Learning Pawsibilities

to seek appropriate medical treatment for

my pet.

I understand that every effort will be made to take my pet to

the vet clinic specified on the emergency form if the situation

permits however; Learning Pawsibilities has the authority to seek

treatment at any veterinary clinic.

Furthermore, I agree to reimburse Learning Pawsibilities within

14 days of incident for veterinary fees and all related costs

including transportation in any amount up to $_____________

(please specify dollar amount per pet. Common amounts are

$200, $1000, or unlimited).

This release does not expire and will remain valid for all future

Learning Pawsibilities services.

Services Interested in:

o _Daycare o _Boarding o _Dog Training o _Bath, Nails Other:

__________________________________

How did you hear

Day Care And Boarding Enrolment Forms Page 3