East Polk Dog Resort

Dog Boarding Information Sheet

Your Name ________________________________________________________________
Street Address ______________________________________________________________
City, State, Zip ______________________________________________________________
Home # __________________
Work # __________________ Email _____________________________________
Cell # ___________________ How did you hear about us? ___________________

In case of emergency, whom do we contact? (other than you or your vet) _______________
__________________________________________________________________________
Is anyone else authorized to pick up your pet(s) and/or make payments towards East Polk Dog Resort)
__________________________________________________________________________

Vet’s name or Clinic _________________________________________________________

Location _________________________ Phone # __________________________________

1st Pets Name ________________________ Breed ________________ Color ___________

Birthday or Age________________________ Male or Female Altered? Yes or No
2nd Pets Name ________________________ Breed ________________ Color ___________
Birthday or Age________________________ Male or Female Altered? Yes or No
Any Special Feeding instructions? _____________________________________________
If more than one pet, do they need to be separated to dine?__________________________
Who is the more aggressive diner? _____________________________________________
How well does your pet interact with other pets? __________________________________
Has your pet bitten another pet or human? _______________________________________

What words do you use for the following:

Treats_____________________________ Bedtime___________________________
Dinner time________________________ Potty______________________________
Any Special Nickname _______________ Do they know how to SIT_____________
Do they know any other commands?________________________________________
What is your pet’s favorite game to play?________________________________________
What is your pet’s favorite form of affection?_____________________________________

Is your pet allergic to anything?_______________________________________________

Is your pet afraid of thunder and lightning? _____Yes _____NO
If YES, how afraid? _____Just a little _____Very afraid
_____Needs to be medicated
Does your pet have any other fears or anxieties?_________________________________
Additional comments____________________________________________________
_____________________________________________________________________
All boarding clients must sign the attached boarding contract for each pet boarded, on an
annual basis.

East Polk Dog Resort Boarding Contract

This is a contract between EAST POLK DOG RESORT and the pet owner whose
signature appears below (hereinafter called “Owner”).

1. OWNER agrees to pay the rate for boarding in effect the date the pet is checked
into EAST POLK DOG RESORT, and further agrees to pay for all costs and
charges for any special services requested, and all veterinary costs for the pet
during the time pet is in care of EAST POLK DOG RESORT.
2. OWNER agrees that the pet shall not leave EAST POLK DOG RESORT until all
charges for boarding, medicine, veterinary services, etc. are paid to EAST POLK
DOG RESORT by OWNER. If the pet is not called for within 10 days of the
stated pickup date, the pet will be sold for bills due or placed with a humane
society or rescue group. OWNER shall be liable for any unpaid charges.
3. OWNER is aware that if pet is found to have fleas or evidence of fleas, that EAST
POLK DOG RESORT requires the pet have a flea shampoo or flea treatment
before being admitted to the kennel.
4. When requested, EAST POLK DOG RESORT will board more than one pet of
the same species, from the same household, in a single kennel; however, EAST
POLK DOG RESORT reserves the right to place the pets in separate kennels if
they deem necessary. The single kennel rate will then apply for each pet.
5. If PET is to be boarded any time over holiday periods, as posted at EAST POLK
DOG RESORT, I OWNER agree that I will pay for ALL DAYS
RESERVED, unless said dates are cancelled at least 72 hours prior to the day of
the reservation.
6. EAST POLK DOG RESORT will exercise due and reasonable care for pet and
will keep its facility clean and properly enclosed.
7. If pet becomes ill or if the state of the pet’s health requires professional attention,
EAST POLK DOG RESORT, in its sole discretion, may engage the services of a
veterinarian or administer medicine, or a special diet, or give other requisite
attention to the pet and the expenses thereof shall be paid by the OWNER.
8. All pets are boarded by EAST POLK DOG RESORT without liability on our part
for loss or damage, from disease, death, running away, theft, fire, injury to
persons, or other animals or property by said pet, fence climbing, or other
unavoidable causes, due diligence and normal care and caution having been
exercised.
9. It is expressly agreed by OWNER and EAST POLK DOG RESORT that EAST
POLK DOG RESORT liability shall in no event exceed the lesser of the current
chattel value of a pet of the same species or the sum of $400.00 per pet boarded.
The OWNER further agrees to be solely responsible for any and all acts or
behavior of said pet while it is in the care of EAST POLK DOG RESORT.
 10. By signing this Contract and leaving your pet with EAST POLK DOG RESORT,
OWNER certifies to the accuracy of all information provided about pet, that pet is
current on all vaccines required by EAST POLK DOG RESORT, that pet has not
been exposed to rabies or distemper within a 30 day period prior to boarding, and
that OWNER is the legal owner of said pet, free and clear of all liens and
encumbrances and assumes financial liability for all payments called for in this
agreement.
11. 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 EAST POLK DOG RESORT.
12. Any controversy or claim arising out of or relating to this contract, or the breach
thereof, or as the result of any claim or controversy involving the alleged
negligence by any party to this contract, shall be settled by arbitration in
accordance with the rules of the American Arbitration Association, and
judgement upon the award rendered by an arbitrator may be entered in any Court
having jurisdiction thereof. The arbitrator shall, as part of his award, determine an
award to the prevailing party of the costs of such arbitration and reasonable
attorney’s fees of the prevailing party.
13. This Contract applies to this stay at EAST POLK DOG RESORT as well as all
subsequent stays for one year.

I have read this agreement on this date, ___/___/___, understand its terms and signed it
freely.

Signature of Owner or Owner’s Agent:

_________________________________________

Signature of East Polk Dog Resort Representative:

______________________________________