Boarding/Daycare Liability Waiver And Service AgreementBoarding/Daycare Liability Waiver And Service Agreement Date* MM slash DD slash YYYY Name* First Last Email* Phone*Alternative PhoneDog/Cat Name*Dog/Cat Name*Dog/Cat NameDog/Cat NamePlease acknowledge the following policy statements by writing your initials in the boxes provided. If you do not agree to all statements, please do not complete this form, and contact Back Bay Veterinary Hospital (BBVH) directly for more information. BY SIGNING BELOW, in consideration of the services rendered by Back Bay Veterinary Hospital to my dog(s) and/or cat(s), I acknowledge reading, understanding, and accepting the statements herein. AGREEMENT TO PARTICIPATE AND LIABILITY WAIVER I understand certain “activities” that my dog may participate in, including daycare, boarding, one-on-one play. Exposure to parasites, viruses, and other medical conditions passed from dog-to-dog or person-to-dog; Sprains, strains, bites, broken bones; Fatigue, dehydration, nicks, cuts, or death. I further understand that not each and every potential risk can be listed above but, nonetheless agree that the benefits associated with dog socialization outweigh the possible risks, therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify Back Bay Veterinary Hospital and its agents, successors, heirs, from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my dog’s participation in activities at Back Bay Veterinary Hospital, including those allegedly attributable to the negligent acts or omissions of Back Bay Veterinary Hospital or their staff.Please initial next to the following policiesFurther, I understand that I may be exposed to certain risks when bringing my dog to participate in activities at Back Bay Veterinary Hospital or when picking up my dog from participating in activities at Back Bay Veterinary Hospital. Such risks may include property damage and/or physical injury inside or outside the facility, such as from falling, slipping, illness, and/or dog bites. Therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify Back Bay Veterinary Hospital, its agents, successors, heirs from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my dog’s participation in activities at Back Bay Veterinary Hospital, including those allegedly attributable to the negligent acts or omissions of Back Bay Veterinary Hospital or their staff.*AUTHORIZATION OF MEDICAL CAREIf my dog is ill or injured while participating in activities at BBVH, BBVH will make every reasonable effort to reach me pursuant to the contact information I have provided BBVH. However, if BBVH is unable to reach me, I consent to BBVH seeking appropriate veterinary care and I accept responsibility for any and all associated expenses. BBVH will not pay any portion of veterinary expenses associated with seeking medical care for my dog if so necessary.*ALLERGIES, SPECIAL DIETS, MEDICATIONSI agree that I will disclose to BBVH any allergies my dog may have. I further agree to disclose to BBVH any special dietary needs or medications my dog may require if necessary during activities at BBVH. I also understand that there are additional fees for administering medications to my pet while boarding.*PHOTOGRAPHS, VIDEOS AND STATEMENTSI authorize use of my dog's visual image(s) and statements in newsletters, posters, social media and other materials.*VICIOUS TENDENCIESI affirm that I am not aware of any vicious tendencies by my Dog. I represent that my dog is sociable and has not harmed or shown threatening behaviors towards any person or any other dog. I understand BBVH reserves the right to remove my dog from the play area and place my dog in a separate holding area if my dog displays any unwanted behaviors. I also understand that BBVH reserves the right to permanently remove a dog from its daycare or boarding facilities at anytime.*AGREEMENT TO PAY BBVH accepts cash or credit cards. I agree to pay the service rates in effect for my dog’s participation in activities at BBVH. I further agree to pay for any additional services requested such as grooming or bathing. A valid credit card must be kept on file at all times. Charges not paid in advance will be charged to Client’s credit card. All services must be paid in full before dog will be released to client. Daycare: There are no refunds for partial daycare. Daycare available 6 days a week during office hours. Check in and Check out only during open office hours. Check in/check out: 7:00 a.m. - 7:00pm Monday-Friday Check in/check out: 8:00am - 4:00pm Saturday- Sunday Boarding: All boarding cancellations must be made 24 hours prior to check in. A 50 % deposit of the total cost of reservation is required upon booking. A full refund may be given if cancelling 72 hours in advance. If cancelling within 24 hours, deposit will not be refunded. No shows will be charged the full amount of reservation.Price for boarding may change without notice. Payment for services rendered is required at pet(s) release, and that pet(s) released AFTER 12:00 NOON (check-out time) WILL BE CHARGED FOR A FULL DAY. If my pet is bathed I am not charged for the last day of boarding and pick-up is after 12:00 noon.*VACCINATIONS AND PARASITE PREVENTION I understand that while my dog is fully vaccinated that vaccines are not guaranteed and there is a small risk that my dog may contract a contagious disease or illness. I agree that should this occur I am responsible for my own pet’s care and medical attention. I agree to allow 7 days waiting period after my dog has had their vaccinations to allow the vaccinations to reach full protection potential and to ensure my dog has not had any negative reaction to the vaccines. Should I allow my dog to stay at Back Bay Veterinary Hospital Daycare and Boarding Facility less than 7 days after vaccination i understand that my dog could be at risk of contracting a contagious virus/disease. All pets staying within BBVH must be free of external and internal parasites. Any petsfound to have parasites will be immediately treated with an anti-parasitic medication at additional expense to the owner.If fleas are present on my pet, an application of topical flea control will be applied at the single dose fee.* If your pet is to be picked up by someone other than you fill in the provided form. All leashes and collars should be removed. We provide bedding and food dishes for all pets so they are comfortable during their stay. This agreement is valid from the date below and grants permission for future veterinary care without the need of additional authorizations each time BBVH cares for my pet(s). The act of my delivering my pet to the BBVH at this time or any time in the future indicates approval. There is no 24 hour personnel on site. I understand that the hospital is NOT staffed after hours at night.Digital Signature* First Last Date* MM slash DD slash YYYY CAPTCHA