Waiver Form

Owner _______________________ Telephone __________________ Vet ______________________


Breed _________________________________ Age ______________ Sex ______________________

Color ___________________________________   Pet Name _________________________________

Emergency Telephone Number ______________

Has Your Pet Ever Bitten Another Person? __________  Another Pet?_________

Special Instructions: _____________________________________________________________________________________


This is an Agreement between Oak Knob Kennels (Business Name) and the pet owner whose signature appears below (hereinafter called “Owner”).

1. Owner agrees to pay all costs and charges for services requested, and all veterinary costs for the pet during the period said pet is in the care of (business name).

2. Owner further agrees that the pet shall not leave the facility until all charges due are paid by Owner.

3. By signing this Agreement and leaving pet with (business name), Owner certifies to the accuracy of all information given about said pet. (business name) reserves the right to deny admittance to Owner’s pet for any reason at any time.

4. (Business name) shall exercise reasonable care for the pet delivered by the Owner to the pet care provider. If interactive daycare is provided, Owner recognizes and accepts potential risks involved in such activity. 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 the pet care provider, to include payment of costs for injury to staff or other animals or damage to facilities caused by the pet.

5. Owner specifically represents that he or she is the sole owner of the pet.

6. Owner specifically represents to (business name) that, to Owner’s knowledge, the pet has not been exposed to any contagious diseases within a thirty-day period prior to check in. Owner further agrees to maintain currency of vaccinations as required by (business name) policy.

7. Owner further represents the pet is free of external and internal parasites (ex. ticks, fleas, etc.). If treatment is determined necessary by the pet care provider, owner agrees to pay for the costs of the treatment.

8. If pet becomes ill or injured, or if the state of the animal’s health otherwise requires professional attention, (business name), in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the animal, and the expenses thereof shall be paid by the Owner.


Business Rep. _____________________ Owner ______________________ Date _____________

Please review the waiver form below. Print, read, and sign prior to arrival.

Waiver Form

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