Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Backup Phone

(###)

###

####

My dog is staying for

Boarding

Day Care

Drop off Date *

MM

DD

YYYY

Pick up Date *

MM

DD

YYYY

I have provided a copy of my dog’s vaccination record (via email to mtndoglife@gmail.com or paper copy) to confirm they are current on Rabies, Bordetella, Distemper, Parvo & Leptospirosis vaccinations. This record shows the dog’s name, owner info & veterinary clinic name/info. * *

Yes

No

I understand that vaccines given less than 10 days prior to boarding, may have limited protective effect for my pet(s). I also understand that the Bordetella vaccine may not protect against ALL strains of kennel cough.

Yes

No

I understand my dog(s) will be co-mingled with other dog(s) for the purpose of exercise and socialization. I certify that my dog (if older than 6 months) is neutered (male) or spayed (female).

Yes

No

I understand that my dog(s) will be kenneled at night, when not supervised by a Mountain Dogs employee or if they become aggressive with other dogs. I understand that if they escape the kennel, are injured in that process, damage the kennel or other property, that Mountain Dogs is not responsible and I may be charged for the damage caused by my dog. *

Yes

No

I understand that while my dog(s) is/are at Mountain Dogs a bite may occur that causes injury to my dog or my dog may cause injury to another dog.

Yes

No

I authorize Mountain Dogs staff to take my dog(s) to a veterinarian, AT MY EXPENSE, if any medical condition arises that staff deem needs veterinary care or should my dog(s) die while in the care of Mountain Dogs.

Yes

No

I have disclosed all my pet’s medical needs, habits, social skills, fears and any other conditions they may have. Failure to fully disclose an animal’s complete disposition may result in injury to your pet or to other pets leading to veterinary care, termination from boarding with Mountain Dogs and/or transfer to another facility all at OWNERS EXPENSE.

Yes

No

I consent to the use of any photos taken of my dog(s) for advertising or marketing of Mountain Dogs

Yes

No

I acknowledge that an additional fee will be charged for pre-arranged check in / pickup outside of normal business hours if staffing is available. This fee may be charged prior to the visit and is non-refundable.

Yes

No

I consent to provide a valid credit card to be kept on file and/or pre-paid deposit to secure my reservation.

Yes

No

I acknowledge that I have read and agree to the "Reservation Changes, Cancellation, 'No Show' Policy".

Yes

No

I certify that all information provided is true and accurate to the best of my abilities. *

Yes

No