New Boarding and Daycare Enrollment Location*DoralMiami GardenOwner InformationFirst Name:*Last Name:*Home Phone:Cell Phone:*Email:* Owner AddressAddress:*Apt/Suite:City:*State:*Zip Code:*Dog #1 InformationName:*Breed:** Color: Weight: * Birthday: Age: SEX*MaleFemaleSPAYED/NEUTERED:*YesNoDog #2 InformationName:Breed: Color: Weight: Birthday: Age: SEXMaleFemaleSPAYED/NEUTERED:YesNoDog #3 InformationName:Breed: Color: Weight: Birthday: Age: SEXMaleFemaleSPAYED/NEUTERED:YesNoEmergency ContactName:*Phone:*Authorized Guardian (Authorized person other than owner, to pick-up and drop-off pet(s)Name:*Phone:*Name:Phone:Veterinarian Contact InformationClinic / Hospital Name:Vet Name:Address:Phone:Contact — AgreementI,*hereby certify that my dog(s):*Once this enrollment form is submitted, someone will contact you within 24 business hours to schedule your reservation: is/are in good health and have not been ill with any communicable condition in the last 14 days. I further certify that my dog(s) have not harmed or shown aggressive or threatening behavior towards any person or any other dog. I have read and understand the following: I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending Doggies Gone Wild. I further understand and agree that during normal play, my dog may sustain injuries. All dog play is carefully supervised by Doggies Gone Wild to help prevent injury, but scratches, punctures, torn ligaments, raw paw, bloating etc. May occur despite the best supervision. I further understand and agree that in admitting my dog(s) to Doggies Gone Wild, Doggies Gone Wild relied on my representations that my dog(s) is/are in good health and have not harmed, shown aggression, or exhibited any threatening behavior towards any person or other dog. I further understand and agree that neither Doggies Gone Wild nor any of its employees, staff, or volunteers, will be liable for any illness, injury, death, and/or escape of my dog(s) provided that reasonable care and precautions are followed, and I hereby release all of them of any liability of any kind whatsoever arising from or as a result of my dog(s) attendance or participation at doggies gone wild. I further understand and agree that any behavioral or health problems that develop with my dog(s) while at Doggies Gone Wild will be handled and treated as deemed best by the employees, staff, and volunteers of Doggies Gone Wild, in their sole discretion, and i assume full financial responsibility for any and all expenses involved. I further understand and agree that my dog(s) must at all times while attending Doggies Gone Wild have current vaccination status. All dogs must be in good health. Owners will need to verify that their dog(s) is in good health and has not been ill with a communicable condition in the last 30 days. On admission, all dogs must be free from any condition that could potentially jeopardize themselves or other guests. All dogs are required to have a veterinarian certification of good health after any illness. We reserve the right to seek veterinary care for any illness or injury, at our sole discretion, while your dog is in our care. Whenever possible, we will attempt to call you or your emergency contact to discuss the matter ahead of time. However, if circumstances do not permit the time necessary to call or if we are unable to reach you or your emergency contact, we will proceed as we see fit. You will be responsible for all charges incurred for any veterinary care and related services provided to your dog while in our care. I further understand and agree that if my female dog(s) is/are not spayed I should not bring her to Doggies Gone Wild while she is in heat and I will not hold responsible any employees, staff and Doggies Gone Wild itself if the female dog gets pregnant. I further understand and agree that if my dog(s) is/are not picked up by the end of the Doggies Gone Wild regular business day, then I hereby authorize Doggies Gone Wild to take whatever action is deemed necessary for the continuing care of my dog(s) and I agree to pay all costs of continuing such care upon demand by Doggies Gone Wild. With regards to grooming or bathing, Doggies Gone Wild will not be held responsible for clipper burn and/or minor nicks resulting from grooming of matted, neglected coats or for irritation caused by removing coat from pets possessing mild to severe skin allergy, nor will be held responsible for stressful effects grooming may have upon a geriatric dog. Doggies Gone Wild reserves the right to charge additional fees for services considered over and above the norm covered by our standing rates. Doggies Gone Wild reserves the right to refuse service to customers who’s pet may pose a threat to employees and other pets left in our care, whether it be due to aggression, health, or parasites other than fleas. If I do not provide my dog with his/her own food while his/her stay in the facility, I hereby grant Doggies Gone Wild the permission to feed my dog the brand of food they carry. I understand there is a risk involved in dietary change and I will not hold any employee, staff member, or Doggies Gone Wild itself responsible if my dog experiences symptoms rising from dietary change, including but not limited to soft stool, diarrhea, huge, etc. Should my dog need medical attention due to this dietary change, I hereby assume all cost and liability. In case of emergency or for the use of the transportation services in the company vehicle, i recognize the risks that accompany said transport and acknowledge that this agreement is being relied upon by Doggies Gone Wild to permit transport of my dog(s) to and from Doggies Gone Wild or any other necessary location. I accept any and all risks, conditions, rules and regulations promulgated by Doggies Gone Wild associated with the activities, use of the facilities and transport, and hereby agree to comply with them and to assume all costs if an incident during transport were to occur. Furthermore, if client is not present at the agreed time during pick up and/or delivery Doggies Gone Wild will continue route and client will still be charged applicable fees. I hereby grant to Doggies Gone Wild the irrevocable and unrestricted right to use and publish photographs/videos of my dog(s) or in photographs/videos my dog(s) may be included. The photographs/videos may be used for social media, advertising, and any other purpose and in any manner and medium; and to alter the same without restriction. I herby release Doggies Gone Wild from all claims and liability relating to said photographs/videos and am aware there is no compensation to be received by me from Doggies Gone Wild after said photographs/videos have been released. Doggies Gone Wild requires to have all dogs vaccinated with bordetella. All measurements and precautions are taken in order to minimize this condition; however, even in the most hygienic, well ventilated, spacious kennels the possibility of a dog acquiring kennel cough exists. Many dogs will have protective levels of immunity to kennel cough via minor exposures to the infective organisms and simply will not acquire the disease even if exposed. Also, boarding my dog(s) within a short period of administering the bordetella vaccine, highly increases the risk of my dog(s) getting the virus. For these reasons, I will not hold any employee, staff member, or Doggies Gone Wild itself responsible if my dog(s) gets sick and I will be liable for any medical expenses if my dog(s) acquires the virus. I understand and agree that each and every of the foregoing provisions contained in the paragraphs above shall be in full force and effect and shall apply to each and every occasion on which I deposit my dog(s) with Doggies Gone Wild and this agreement shall remain in full force and effect until and unless otherwise cancelled or superseded by a writing signed by the parties. I also certify that I have read and understand the policies of Doggies Gone Wild and that I have read and understand the conditions and statements of this agreement, and I agree to abide and be bound by these rules and regulations.By clicking submit you are agreeing to the terms of this Contract - AgreementCAPTCHACommentsThis field is for validation purposes and should be left unchanged.