Fields marked with an * are required
Signature and date at bottom of page must be filled out before form will be accepted.
CREDIT CARD INFORMATION (American Express not accepted)
If you have multiple dog's please fill out a form for each. On multiple forms, under parent information you will need to include First/Last Name and Email address. Repetitive information is not required.
Note: If you have not provided an individual form for each pet, the waiver signed on this form will apply to all personal dogs in our care.
BEHAVIORAL INFORMATION (Check all that apply)
PLAY SIDES Our trained staff will evaluate your dog to determine the best fit, but please indicate the preferred play group your dog can join in. You can check both.
Temperament Test & Behavioral Assessment
Day-Play is a cage-free service designed for social dogs to play and have fun. Safety is our primary goal. We do require a trial day prior to your dog(s) first Day Play or Boarding stay. Testing is by appointment only and is performed by a Senior Haven Staff Member. The cost is $20. On the day of test, we ask for approximately 4-6 hours, this will allow us adequate time to slowly evaluate and hopefully integrate your dog into our system.
Other Medical. To help us better care for your dog, please list -
BOARDING / DAY PLAY Information
HAVEN/OWNERS RIGHTS & RESPONSIBILITIES
This is a contract between HAVEN-The Dog Spot, LLC (hereinafter referred to as “HAVEN” and the pet owner whose signature appears below ("Owner").
NOTE: If Owner has neglected to provide Haven with an individual registration and signed waiver for each personal dog in Haven's care, Haven will act accordingly under the sole signed waiver and its rights and responsibilities clauses.
1. Owner certifies the accuracy of all information Owner has conveyed about Owner's pet to HAVEN.
2. Owner specifically represents to HAVEN that Owner's pet has not been exposed to any contagious or communicable disease within a thirty-day period prior to using HAVEN's services. Owner agrees to notify HAVEN of any exposure to any virus, infection or other illness, and will not bring pet to HAVEN until pet is symptom-free for a reasonable period (to be determined by pet's Veterinarian), or until written approval is obtained from a veterinarian. Owner further agrees not to bring pet to HAVEN if pet is exhibiting any signs of illness, such as: vomiting, diarrhea, unusual sleepiness, etc. that may be potentially harmful to other pets at HAVEN. If necessary, you authorize HAVEN to obtain medical and vaccination records for your dog from the veterinarian listed and you hereby authorize your veterinarian to provide these records to HAVEN.
3. Owner agrees that if Owner's pet becomes ill or otherwise requires professional attention, HAVEN, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other necessary attention to the pet, and any expenses incurred thereto shall be paid by the Owner. Owner gives consent to HAVEN to act in the Owner's behalf in obtaining emergency veterinary care at Owner's expense if deemed necessary by HAVEN or any of its employees. Owner agrees to indemnify and holds HAVEN and its employees harmless from said expenses. In the case of a medical emergency, the maximum dollar amount that owner authorizes to be spent on veterinary care is $ (please fill in amount, i.e., $1000, $5000, unlimited, etc.)
4. Owner represents to HAVEN that all personal information, including credit card information, that Owner has provided to HAVEN is accurate.
5. Owner agrees to pay the rate for any service in effect on the date Owner checks Owner's pet into HAVEN, as stated by HAVEN.
6. Owner further agrees to pay all charges for special services requested, all veterinary costs for pet during the time said pet is in the care of HAVEN, and all fees incurred by Owner through Owner's failure to comply with HAVEN's Cancellation Policy.
7. Owner agrees that HAVEN may collect amounts owed by Owner due to Owner's failure to comply with HAVEN's Cancellation Policy by charging such amounts to Owner's credit card. All other charges incurred by Owner shall be payable upon pick-up of Owner's pet.
8. Owner hereby grants HAVEN the legal right to collect for any and all unpaid charges resulting from boarding, day care or any other service provided by HAVEN.
9. Owner assumes any and all expenses or liability for injuries that Owner's pet may inflict upon any human or other pet while in HAVEN. Owner agrees to indemnify and hold HAVEN and its employees harmless from any and all expenses and liability incurred as a result of injuries Owner's pet inflicts upon any human or other pet while in HAVEN.
10. Owner hereby grants HAVEN the right to take photographs of Owner's pet while HAVEN is caring for Owner's pet, and to post or reproduce any and all photographs taken (as well as Owner's pet's name) on or in, without limitation, HAVEN's web site, promotional materials and merchandise, without becoming liable to the Owner (or the Owner's pet) for any royalty payment of any kind.
11. HAVEN shall exercise reasonable care for Owner's pet while Owner's pet is in HAVEN's custody. The Owner recognizes the potential risks involved with group play/dog day care, boarding, and grooming due to the unpredictable nature of dogs. Dogs playing together in playgroups can sometimes result in injuries or spreading of such airborne illnesses as Kennel Cough. Dogs during their unsupervised time in kennels can potentially be harmed by eating toys/treats.
12. HAVEN reserves the right to change the level or type of daycare/boarding or remove the pet from group play, if in its sole discretion it is believed necessary to ensure the safety of the pet, other dogs or its employees.
13. It is expressly agreed by Owner and HAVEN that HAVEN'S liability shall in no event exceed the lesser of the current chattel value of a pet of the same breed/kind or the sum of $400 per animal boarded. It is expressly agreed by Owner and HAVEN that HAVEN has no liability for animals not neutered or spayed; and no liability if dog is unable to be contained in our facility (i.e. fence jumpers and escape artist dogs).
14. 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 HAVEN.
15. This Contract shall be interpreted under the laws of the State of Georgia. 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 resolved in the trial courts of Cobb County, State of Georgia.
Comment area for item #3 under Rights/Responsibilities:
By signing and dating the fields below, you agree to the terms & conditions above.