Owner Information:
Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email Address:
Emergency Contact:
Persons Authorized to drop off and pick up my pet:
Name(s):
Veterinarian Information:
Vet Clinic/Hospital Name:
Please Note: All pet's vaccination records should be faxed or brought to our office prior to check-in. This will help speed up the check-in process
Hierarchy Farm hereinafter referred to as the “Farm”, agrees to exercise due and reasonable care and to keep the premises sanitary and properly enclosed. Your pet(s) will be fed, have access to water at all times and housed in safe, clean quarters.
The services we provide are done so without liability for loss or damage from disease, death, running away, theft or fire, and from injury or damage done by your pet(s) to people, other animals or property, or other unavoidable causes. Due diligence and care has been exercised.
Should any pet become ill or need medical attention, we reserve the right to administer aid and to render care by your local designated veterinarian, if available, or by our veterinarian. Any expenses shall be paid promptly by the Owner.
Owner specifically represents that the pet(s) is kept current on vaccinations and has not been exposed to distemper, parvo, rabies, or canine cough within 30 days prior to boarding.
Owner agrees to pay the rate for boarding in effect on the date the pet(s) is checked into the Farm, and further agrees to pay for all costs and charges for special services requested upon check-in.
No pet will be released until all charges are paid in full or other arrangements satisfactory to the Farm have been made. The customer agrees to notify us in advance if there is any change in the pets’ pick up date, or person picking up said pet(s). Any pet left uncalled for seven days from the scheduled date of pickup, as noted herein, shall be considered abandoned and will become the property of the Hierarchy Farm and may be sold or disposed of.
The owner of this pet(s) or his agent agrees to pay reasonable legal fees and costs incurred by the Farm in the collection of outstanding bills.
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 judgment 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.
By signing this Contract and leaving your pet(s) with the Farm, Owner certifies to the accuracy of all information given on the Pet and Owner Information pages.
Pet Owner:
Hierarchy Farm
Date:
