Boarding Form

Please Note: Filling out this form does not guarantee a boarding spot. Please call our office to check availability and make your pet's reservation.

ALL ANIMALS MUST BE CURRENT ON ALL CORE VACCINATIONS. Core vaccines are rabies, distemper/parvo, kennel cough, and the canine influenza vaccine. Proof of vaccinations must be shown within
one hour of check-in or they will be given at owner’s expense.

All animals must be free of internal and external parasites (fleas, ticks, ear mites & intestinal worms) or they
will be treated at the owner’s expense.

One of the advantages of boarding your pet(s) at a veterinary clinic or hospital is that veterinary attention is
available should the need arise. If your pet becomes ill or injured, we will call the emergency number(s) listed
above regarding your pet(s) symptoms, treatment options, and estimate of additional cost. If no one can be
reached, I give Animal Medical Center of Cumming, Inc. permission to treat, prescribe for, operate upon,
and/or transport the pet to an appropriate facility as necessary and adjust the bill accordingly.

Medications given while boarding are administered by trained technicians and documented in the patient’s
chart. There is an additional fee per day. Medication fee is waived if your pet participates in playtime.

We are not responsible for personal items brought by owner.

Regular: Dogs are walked and cat cages are cleaned twice daily, fed according to owner’s specifications, and
must be current on all vaccinations. Pets will lodge in size appropriate cages. Baths, toenail trims, and
medications may be administered for an additional fee.

Playtime Package: In addition to regular lodging services, dogs will receive group play/socialization time twice a day and a bed-time snack for an additional fee. Cats will receive individual time with staff members as well as play time on the cat tree. For every day of play, medications will be given at no additional cost.

Additional details
The purpose of Group Play offered in our TLC (Playtime) Package is to provide a safe, fun and
stimulating social environment for our lodging dogs. Dogs will be able to exercise during action packed
sessions where they will learn social skills and have personal interaction with trained team members
as well as other dogs. This type of play will also provide an often much-needed outlet for high-energy
dogs. If your dog doesn’t socialize well with other dogs, one-on-one time will be offered instead with all
of the aforementioned benefits. Activities will vary, but rest assured that your dog will be under
constant supervision by our trained staff. We understand that not all dogs play the same, so dogs will
be let out in groups are appropriately sized. Size, breed, age and demeanor will all be determining
factors when placing them within the appropriate group.

My dog is currently heartworm negative and on flea prevention.

I certify that I have fully disclosed any situations where my dog may have shown any type of aggressive behavior.

I understand that participation in group play and allowing the freedom of dogs to interact is not without risk. Dogs are
not always predictable, and the unexpected may occur. If my dog does show aggressive tendencies and/or does not
socialize well with other dogs, I understand that no more group play will be allowed. I hereby waive and release Animal
Medical Center of Cumming (AMC) and its staff from any and all claims while on the premises. I release AMC of any
liability and assume all risks of any kind whatsoever arising from my dog’s attendance and participation in group play. If
my dog causes injury to another dog or to a person while at AMC, I agree to indemnify and hold blameless AMC from
any claims which may be made against it.

I further understand and agree that any problems which may develop with my dog will be treated as deemed best by
the veterinarians and staff at AMC and that I assume full financial responsibility for any expenses involved.

I hereby authorize AMC, its employees, representatives or agents to receive, care for, vaccinate, prescribe for,
medicate, test, and/or bathe my animals as they deem necessary for the health, safety or well-being of my pet.

I understand that all reasonable precautions against injury, escape or death of my pet will be used. In the absence of
gross negligence, I thoroughly understand that I assume certain risks and will not hold AMC, its employees,
representatives or agents liable or responsible in any manner or circumstances for these risks.

Lastly, I understand that all responsibility for payment for services provided in this office for my pet is mine, due and
payable at the time services are rendered.