Registration | Detachment Canine

Dog Boarding Registration

Please complete the registration form below before dropping your pet off for their visit. If you are boarding more than one dog, please submit one form for each dog.

If you have any questions, contact Steven at 585.451.9916 or detachmentcaninellc@gmail.com

OWNER'S INFORMATION

First Name

Last Name

Street Address

City

Region/State/Province

Postal / Zip code

Phone

Other Individual Dog Can Be Released To

Phone

PET'S INFORMATION

Dog Name

Dog Breed

Color Marking

Age

Gender

Male

Female

Dog Food Brand

Amount Fed Per Feeding

Feeding Schedule

Twice Daily (AM & PM)

Once Daily (AM only)

Once Daily (PM only)

Other

Please Describe Any Medications (Including Name and Dosage)

If other, please describe

Please Upload Your Pet's Vaccination Records Here

Upload File

Liability Waiver

Any references below to the word “I” also implies all others associated with me, including but not limited to my spouse, heirs, assignees, and other family members. Any reference to Detachment Canine LLC implies its owner(s), employees, customers, prospective customers and subcontractors.

This section applies to current and prospective customers, employees, subcontractors, or anyone else that enters the premises of Detachment Canine LLC:

I agree that if I get injured by a dog at Detachment Canine, I will not hold Detachment Canine liable for any injures or damages that may occur.

This section applies to anyone who brings their dog to the Detachment Canine premises for any reason:

I have disclosed to Detachment Canine all known risks, dangerous and medical conditions associated with my dog(s).
I understand that I am solely liable for medical care expenses and damages that result from injuries caused by my dog, or that I will resolve the matter directly with the owner(s) of the other dog(s) based on applicable laws.
I understand that Detachment Canine may refuse service to my dog for any reason it deems necessary, including but not limited to, overly aggressive behavior and illness.
I agree that there are inherent risks in sending my dog to any dog boarding facility, such as illness or injury, and I accept these risks because they are outweighed by the benefits. Detachment Canine will not be liable for any illness or injury that may occur to my dog(s).
I authorize Detachment Canine to take actions they deem necessary to insure the health, well-being, and safety of my dog(s), and to take reasonable action to resolve any medical problems that may arise while my dog(s) is in their care. I agree to assume full financial responsibility for any and all medical expenses incurred as a result of their actions. I understand that Detachment Canine is expected to make a reasonable attempt to contact me before incurring such expenses, that they may need to incur such expenses if they cant reach me, and that an emergency situation could arise where it would not be feasible for them to contact me before expense incurred.
I understand that, as is the norm in the pet care industry, under no circumstances will Detachment Canine LLC be liable for damages beyond replacement value for the dog(s).
I waive all claims or actions against Detachment Canine LLC, relating to the care, control, health, and or safety of my dog(s) arising while in their care.

I authorize Detachment Canine to allow my dog(s) to socialize and/or play with other dogs while they are on the premises.

Yes

I certify that:

I am the legal owner of the dog(s) I am sending to Detachment Canine
That my dog(s) is currently and properly registered
That to my knowledge my dog has not been exposed to kennel cough, distemper, rabies or parvovirus within the last thirty days.
My dog has been vaccinated as indicated by vet records.

Your Signature

Print Name

Date

Thanks for submitting!

DETACHMENT CANINE

Dog Boarding Registration

OWNER'S INFORMATION

PET'S INFORMATION

DETACHMENT
CANINE