Name* First Last Pet's Name (Opportunity to add additional pets at bottom of form)*Age*Phone*Drop-off Date* MM slash DD slash YYYY Please note: we do NOT accept drop-offs the following times during the week: - Monday, Friday: *8:00am-8:15am *9:00am-9:15am *5:00pm-5:30pm - Tuesday - Thursday: *7:00am-7:30am *9:00am-9:15am *6:30pm-7:00pm - Saturday *8:00am-8:15am *9:00am-9:15am *3:00pm-4:00pm* I understand the aboveDrop-off Time* : Hours Minutes AMPM AM/PMPick-up Date* MM slash DD slash YYYY Pick-up Time* : Hours Minutes AMPM AM/PMPlease note: we do NOT accept pick-ups the following times during the week: - Monday, Friday: *8:00am-8:15am *9:00am-9:15am *5:00pm-5:30pm - Tuesday - Thursday: *7:00am-7:30am *9:00am-9:15am *6:30pm-7:00pm - Saturday *8:00am-8:15am *9:00am-9:15am *3:00pm-4:00pmWeight of pet*Has pet boarded with us before?* Yes NoKennel type requested (Note: Cats and dogs cannot board together)* CANINE: VIP Suite, for dogs of any size: $53.55/day CANINE: VIP Suite shared with another dog in family: $53.55/day for first dog, $39.90/day for second dog FELINE: VIP Suite (includes 30 minutes of playtime daily): $40.95/day FELINE: VIP Suite shared with another cat in family: $40.95/day for first cat, $18.90/day for second CANINE: Large Suite, for dogs of any size: $42/day CANINE: Large Suite shared with another dog in family: $42/day for first dog, $32.55/day for second dog CANINE: Standard Suite, for dogs of any size: $36.75/day CANINE: Standard Suite, for dogs of any size, with roommate: $36.75/day for first dog, $27.30/day for second dog CANINE: Patio Home, $30.45/day CANINE: Townhome, for dogs less than 30 pounds, $28.35/day FELINE: Feline Studio (1 bedroom, 1 bathroom): $23.10 /day for one cat. FELINE: Optional additional bedroom: $15.75/day (required for roommate)Coughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding:* Bringing own food Eating hospital food (additional fee)Bath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during staySpecial Needs Boarder?* Yes NoIncludes diapering (owner-provided), daily spot baths, ear cleaning, injections for $12/daySharing kennel with housemate?* Yes NoPets Name*Age*Weight of Pet*Has pet boarded with us before?* Yes NoCoughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding:* Bringing own food Eating hospital food (additional fee)Bath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during staySecond pet?*Select OneYesNoThis pet will be in housed a separate kennel, as we only allow 2 pets per kennel.Pet's Name*Age*Weight of pet*Has pet boarded with us before?* Yes NoKennel type requested (Note: Cats and dogs cannot board together)* CANINE: VIP Suite, for dogs of any size: $51.00/day CANINE: VIP Suite shared with another dog in family: $51.00/day for first dog, $38.00/day for second dog FELINE: VIP Suite (includes 30 minutes of playtime daily): $39.00/day FELINE: VIP Suite shared with another cat in family: $39.00/day for first cat, $18.00/day for second CANINE: Large Suite, for dogs of any size: $40/day CANINE: Large Suite shared with another dog in family: $40/day for first dog, $31/day for second dog CANINE: Standard Suite, for dogs of any size: $35.00/day CANINE: Standard Suite, for dogs of any size, with roommate: $35.00/day for first dog, $26.00/day for second dog CANINE: Patio Home, $29/day CANINE: Townhome, for dogs less than 30 pounds, $27/day FELINE: Feline Studio (1 bedroom, 1 bathroom): $22.00/day for one cat FELINE: Optional additional bedroom: $15.00/day (required for roommate)Coughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding* Bringing own food Eating hospital food (additional fee)Bath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during staySpecial Needs Boarder?* Yes NoIncludes diapering (owner-provided), daily spot baths, ear cleaning, injections for $12/daySharing kennel with housemate?* Yes NoPets Name*Age*Weight of Pet*Has pet boarded with us before?* Yes NoCoughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding:* Bringing own food Eating hospital food (additional fee)Bath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during stayThird pet?*Select OneYesNoThis pet will be in housed a separate kennel, as we only allow 2 pets per kennel.Pet's Name*Age*Weight of pet*Has pet boarded with us before?* Yes NoKennel type requested (Note: Cats and dogs cannot board together)* CANINE: VIP Suite, for dogs of any size: $51.00/day CANINE: VIP Suite shared with another dog in family: $51.00/day for first dog, $38.00/day for second dog FELINE: VIP Suite (includes 30 minutes of playtime daily): $39.00/day FELINE: VIP Suite shared with another cat in family: $39.00/day for first cat, $18.00/day for second CANINE: Large Suite, for dogs of any size: $40/day CANINE: Large Suite shared with another dog in family: $40/day for first dog, $31/day for second dog CANINE: Standard Suite, for dogs of any size: $35.00/day CANINE: Standard Suite, for dogs of any size, with roommate: $35.00/day for first dog, $26.00/day for second dog CANINE: Patio Home, $29/day CANINE: Townhome, for dogs less than 30 pounds, $27/day FELINE: Feline Studio (1 bedroom, 1 bathroom): $22.00/day for one cat FELINE: Optional additional bedroom: $15.00/day (required for roommate)Coughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding* Yes NoBath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during staySpecial Needs Boarder?* Yes NoIncludes diapering (owner-provided), daily spot baths, ear cleaning, injections for $12/daySharing kennel with housemate?* Yes NoPets Name*Age*Weight of Pet*Has pet boarded with us before?* Yes NoCoughing, Sneezing, Vomiting, Diarrhea* Normal AbnormalEating, Drinking* Normal AbnormalActivity Level* Normal AbnormalDiet Type* Dry Canned Both OtherExplain*How much? (e.g. 1 cup)*How often? (e.g. morning and afternoon)*On any meds or treatments?* Yes NoList below:*how many times a day?*Medical Condition* Yes NoPlease explain*Personal Belongings* Yes NoPlease explain*Does your pet have any food or medication allergies/sensitivities?* Yes NoPlease explain*Has your pet ever bitten a person or other animal?* Yes NoPlease explain*Does your pet ever eat or destroy non-food objects?* Yes NoPlease explain*Does your pet ever jump fences or try to escape the house or yard?* Yes NoPlease explain:*Does your pet get along with other animals? (both cats and dogs)* Yes NoPlease explain*Can your pet play in supervised playgroups?* Yes NoPlease explain*Feeding:* Bringing own food Eating hospital food (additional fee)Bath Requested?* Yes NoComplimentary with stay of 4 or more days.Extra walks or playtime?* Yes NoOther services requested during stayHave you boarded here in the past 30 days?* Yes NoBoarding ContractGeneral Terms: The Bear Valley Veterinary Care Center will exercise responsible care for the safety of your pet, and to keep the boarding premises safe and properly enclosed. Pets will be fed and watered regularly, and housed in clean, safe quarters. The Bear Valley Veterinary Care Center cannot guarantee against accidents, and we cannot be liable for loss or damage caused by or to our pet guests at this facility. Owner agrees to be solely responsible for any and all attacks or damage caused by owners' pet while it is at this resort.* I accept these termsPayment/Nonpayment: The Bear Valley Veterinary Care Center charges for boarding space by the day. Owner agrees to pay the rate for boarding in effect on the day the pet is checked into the resort. Payment balance is due upon checkout. If any charges are not paid when due, interest will accrue at 1.5% per month, or the maximum rate allowed by law. All collection expenses, including attorney fees, will be paid by the owner.* I accept these termsCheck in/out Times: Check out time is by 10:00 AM. Any pet checked out before 10:00 AM will not be charged the boarding fee for the day of check out. Any pet checked out after 10:00 AM will be charged for the day of check out. Check in and check out times are only during normal appointment hours. There are no check-ins or check-outs on Sundays, Holidays, or outside of hospital hours.* I accept these termsPersonal Items: We make every effort possible to make your pet feel at ease while he/she is staying with us. Excluding pet food, the Bear Valley Veterinary Care Center does not recommend bringing personal items from home as they may get lost in the laundry or soiled. Hospital pet food is available if needed for an additional cost. Bear Valley Veterinary Care Center is not responsible for lost or damaged personal items.* I accept these termsVaccinations: Vaccinations are for the protection of your pet, we cannot make exceptions to vaccination requirements. If proof of vaccination is not on file or provided from another veterinarian, the pet will be vaccinated and examined at the owner's expense on the arrival date, and has higher risk of contracting an illness during their stay. There is not a physical examination fee when the kennel cough vaccine alone is given.* I accept these termsAbandonment: If the pet is not called for within 10 days after the designated checkout time, the pet will be considered abandoned and will be handled in accordance with state law. All adoption fees and other incurred expenses will be the responsibility of the owner.* I accept these termsDeparture Baths: We offer a complimentary departure bath for all dogs staying 4 or more consecutive days. If you do NOT want your pet to receive the departure bath, please notify representative at check-in. If your pet is here for less than 4 days and you would like to purchase a basic bath, please let a representative know. For pets leaving on a Monday, baths will be performed on the preceding Saturday. For pets leaving the day after a holiday, the bath will be given on the preceding regularly scheduled business day (when the hospital is open).* I accept these termsDeposit: The Bear Valley Veterinary Care Center requires a non-refundable deposit equal to 50% of the boarding fees at the same time the reservation is made. This deposit guarantees the space for specified guest. All days reserved will be charged for in full, even in the event of late drop off or early return. If an extended stay is required there may be additional fees above routine boarding rates.* I accept these termsGeriatric Pets: Older pets may experience additional stress in the lodging, daycare, grooming, or training environment. The Bear Valley Veterinary Care Center is devoted to providing exceptional care for guests, including geriatric pets. Your signature acknowledges that you are aware of and accept all age related risks to your pet.* I accept these termsMedications: Medications, supplements, or other items will be administered for an additional fee as directed, but medications must be presented in their original containers with instructions for administration.* I accept these termsTreatment Authorization: The owner agrees that Bear Valley Veterinary Care Center, in its discretion, give first aid, medication, or other attention we deem it necessary for the health, and safety of your pet. Bear Valley Veterinary Care Center is authorized by the owner to provide veterinary care, including emergency care, at the owner's expense. If we believe that your pet is in need of care, time permitting we will attempt to contact you before providing that care, but this document serves as our authorization to provide veterinary care for your pet in the event we are unable to reach the owner. The owner is responsible for expenses of veterinary care, whether or not you have been reached in advance. Your signature on this authorization permits Bear Valley Veterinary Care Center to make reasonable care decisions regarding your pet; and the owner agrees to pay for all costs incurred for such treatment. In the unlikely event that a pet passes away while a guest of Bear Valley Veterinary Care Center we will contact you and discuss your options of body care with you.* I accept these termsGroup Play/Daycare Authorization: Group Play and Daycare involve dogs interacting and playing together. Dogs in group play (or group potty breaks) or daycare may play in the water, toss toys, and run with other canine guests. Although there is a supervisor present for these activities, anytime dogs play together there is the possibility of injury from playing rough or combative behavior. There is also an increased risk of transmission of ailments such as parasites, coughs and colds when dogs come into contact with one another. It is advisable to ensure that your dog is on a de-worming protocol. Risks of upper respiratory infections occur in group play at dog parks, on the sidewalk or at Bear Valley Veterinary Care Center, just like human children in daycare or school. Dogs in daycare or group play may get wet. Your signature acknowledges that you are aware of the risks involved with any canine group activities, that you agree to hold Bear Valley Veterinary Care Center harmless of the associated risks and are authorizing your dog to enter into our group play or daycare activities.* I accept these termsMonitoring: Staffing at Bear Valley Veterinary Care Center varies by season and days. If at any time a staff member is not present on the premises, the hospital is locked, monitored by an off-site fire alarm company, and the pets are able to be observed remotely by video camera. For staff safety, dogs are not walked between the hours of 9 pm and 6 am. Boarding kennels are located on the lower level and require pets to be able to maneuver stairs.* I accept these termsReviewed emergency medical protocol?* Yes NoPlease go back and read it!* I hereby agree to the foregoing as the owner of the aforementioned pet(s).* I further certify that my pet(s) is in good health and has not been ill with any communicable condition nor to my knowledge been exposed to any communicable diseases within the last 30 days.* Moreover, I certify to the accuracy of all information given about my pet(s) and have discussed any previous signs of aggression or threatening behavior toward any person or animal.* I have read and understand the entire boarding contract.Your Signature*Δ