ann savoy's country kennels

Ann Savoy's Country Kennels
WAIVER & RELEASE FORM

Name of Dog/Cat: ________________________________________________________

Breed________________________________M F ______________________________

Name of Owner: _________________________________________________________

Telephone: _____________________________________________________________

Email address:__________________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Emergency contact number:_________________________________________________

My signature on this document indicates that I have read it and clearly understand all of its terms.
In consideration of Ann Savoy's Country Kennels (hereinafter referred to as "Ann Savoy") agreeing to board my pet for the price as stated, I agreed as follows

1. I will be responsible for the actions of my dog if it causes any damage whatsoever, including but
     not limited to damage or injury to other dogs, people, or objects while in the care of Ann Savoy.
2. I shall be responsible to carry Liability Insurance and the kennel price reflects that I shall bear that
     cost.
3. Ann Savoy is not responsible for any injury to, or damage, whatsoever caused to or by my dog
     while it is in the care of Ann Savoy.
4. To indemnify Ann Savoy, and her employees and servants from any loss, injury or damage they
     may suffer as a result of the actions of my dog.
5. My dog is suitable to be in the care of Ann Savoy and is not aggressive toward people or other
     animals. My dog is obedient and capable of following instruction.
6. I understand that there are risks involved in having my dog cared for by Ann Savoy. In the event of
     illness or injury, I authorize Ann Savoy to take my dog to the nearest vet considered to be the
     most suitable by Ann Savoy. I agree to pay all vet care required or advised, in the opinion of the
     vet, to the amount of $500. If the required care will exceed that amount, I know that Ann Savoy wil
     l try to contact me at the telephone numbers I have given in this waiver. If they cannot reach me.
     Ann Savoy is authorized to use her best judgment in deciding whether to go ahead with any form
     of treatment recommended by the vet, whether the cost of such treatment exceeds $500 or
     otherwise, and I agree to pay for all such care.
7. I understand that having my dog in the company and environment of other dogs may involve risks
     regarding the contraction of illness. I understand that even regular vaccinations cannot completely
     guard against illness and disease, and that Ann Savoy cannot in any way prevent, nor are they
     responsible for, any illness that my dog might contract.
8. I will ensure that my dog is, and will be kept currently vaccinated.
9. I agree to provide proof of current vaccinations if requested.

Agreed and accepted this ____ day of _______ , 200____.

Owner's signature: __________________________________________________________

Witness' signature: __________________________________________________________

Print name: _______________________________________________________________

Print name: ________________________________________________________________

Ann Savoy's Country Kennels
PH: (506) 757-2509
Fax:(506) 757-8771

Please print off, sign and bring with you when dropping off your pet.