10700 66th Street N

10700 66^th Street N., Pinellas Park, FL 33782

Tele. 727-520-PAWS (7297) Fax. 727-548-4728 www.pawsinnparadise.com

Boarding Application / Questionnaire & Contract Agreement

Owner Information Name:	Address: City, State & Zip:	Veterinarian Information Vet'sName: and/or Hospital Name:	Address: City, State & Zip:
Home Phone Number:	Cell Phone Number:	Vet's Phone Number:
Emergency Contact Name: Relationship to you:	Emergency Contact Number:
Pet #1 Name:	Type Pet: Dog Cat Other	Pet #2 Name:	Type Pet: Dog Cat Other
Male Neutered	Female Spayed	Male Neutered	Female Spayed
Breed:	Color:	Breed:	Color:
Age:	Birth date:	Age:	Birth date:
REQUIRED VACCINATIONS: Please remember to have your Veterinarian fax over the records. If we do not have proof of current vaccinations your pet will not be admitted into the facility. Thank you for your cooperation. *** * * For dogs we require Bordatella, Rabies, and Distemper / Parvo (DHLLP) * * * * * * For cats we require Feline Distemper (FCVRP) and Rabies * * ***
Pet #1	Health & Temperament Questionnaire		Pet #2
Is your pet on any medication? Yes No	If YES, medication name & dose:	Is your pet on any medication? Yes No	If YES, medication name & dose:
Does your pet have any allergies? Yes No	Is your pet a finicky eater? Yes No	Does your pet have any allergies? Yes No	Is your pet a finicky eater? Yes No
Is your pet on a prescription diet? Yes No	If Yes, what brand and any special instructions:	Is your pet on a prescription diet? Yes No	If Yes, what brand and any special instructions:
Is your pet FOOD aggressive/protective? Yes No	Is your pet TOY aggressive/protective? Yes No	Is your pet FOOD aggressive/protective? Yes No	Is your pet TOY aggressive/protective? Yes No
Has your dog ever bitten anyone? Yes No	If yes, were they provoked or did they attack?	Has your dog ever bitten anyone? Yes No	If yes, were they provoked or did they attack?
If your pet(s) run out of food, is it okay to feed our kennel food? We use Blue Buffalo (All Natural) Yes No Please note: Our food is an additional cost.
*** FOOD FROM HOME MUST BE IN SEALED CONTAINERS (ZIPLOCS ARE FINE). *** List any special Boarding instructions:
Health & Temperament Certification I, (Name of Owner) , hereby certify that my pet(s) is/are in good health and has/have not been ill with any communicable disease in the last 30 days. I further certify that my dog(s) has/have not harmed or shown aggressive or threatening behavior towards any person or other dog. Signature: ____________________________________________________________ Date: _______________________________
THIS CONTRACT APPLIES TO ALL PETS BOARDED BY OWNER AND REMAINS IN EFFECT FOR RETURN VISITS
1. The Owner agrees to pay the rate for boarding in effect on the date your pet(s) is checked into the facility. Charges will also apply if picked up after 12 noon on day of check out. 2. Owner further agrees to pay all costs and charges for special services requested and all veterinary costs for your pet during the time the pet is in the care of Paws Inn Paradise, LLC. 3. The Owner further agrees that the pet(s) shall not leave the Inn until all charges are paid to Paws Inn Paradise, LLC by the Owner. 4. By signing this Contract and leaving your pet(s) with Paws Inn Paradise, LLC, the Owner certifies the accuracy of all information given about your pet(s). 5. Paws Inn Paradise, LLC shall exercise reasonable care for your pet(s) for the duration of their stay. It is expressly agreed by Owner and Paws Inn Paradise, LLC that Paws Inn Paradise, LLCs' liability shall in no event exceed the lesser of the current value of the pet of the same species or the sum of $100.00 per animal boarded. The Owner further agrees to be solely responsible for any and all acts or behavior of the pet(s) while in the care of Paws Inn Paradise, LLC. 6. The Owner specifically represents to Paws Inn Paradise, LLC that the pet(s) has not been exposed to rabies, distemper or been ill within a thirty-day period prior to boarding. 7. We require the Bordatella vaccination prior to boarding to help protect against Kennel Cough (Tracheobronchitis) and utilize best sanitation practice daily. Paws Inn Paradise, LLC is not responsible for any cost or expenses related to Kennel Cough or other infectious conditions to which your pet may be exposed. 8. If the pet(s) becomes ill or if the state of the animal's health otherwise requires professional attention, Paws Inn Paradise, LLC, in its sole discretion, may engage the services of a veterinarian, administer medicine or give other requisite attention to the animal, and the expenses shall be paid by the Owner. 9. This Contract contains the entire agreement between the parties. All terms and conditions of the Contract shall be binding on the heirs, administrators, personal representatives and assigns of the Owner and Paws Inn Paradise, LLC. 10. 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 or breach thereof, shall be settled in accordance with the rules of the American Arbitration Association and judgment upon the award rendered by and 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 cost of such arbitration and reasonable attorney's fees of the prevailing party. If you do not understand this contract, contact an attorney before signing. Paws Inn Paradise, LLC Representative _____________________________________________________ Date: ___________________________ Printed Name of Owner: ______________________________________________ Signature of Owner: _________________________________________________ Date: ___________________________