Loading...

*Waiver, Assumption of Risk and Agreement to Hold Harmless*

*Terms & Agreements For All Dogs*

I understand that dog boarding, training, and/or doggie day care at/with Doggy Den Boarding and Daycare or at Ann Anderson’s residence (10240 Principe Place, Camarillo) or on MGI property (5390 Gabbert Rd., Moorpark) is not without risk to myself, members of my family, my guests who may be present, or my dogs, because some of the dogs to which I (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest care. In consideration of, and as an inducement to, the acceptance for my registration for boarding, training, and/or doggie day care, I agree to indemnify and hold harmless, and hereby waive and release DOGGY DEN BOARDING AND DAYCARE, CALIFORNIA SEARCH K-9S, ANN ANDERSON, ROBERT ANDERSON, MIKE GROSSMAN, MGI, GLENN GROSSMAN and each of the above named persons/entities’ employees, owners or agents (hereinafter “RELEASEES”) from any and all liability of any nature, for injury or damage which I, my family or guests or my dogs may suffer, including specifically, but without limitation to, lost dogs, any injury or damage resulting from the action of any dogs including my own, and I expressly assume the risk of any such loss, damage, illness, or injury while boarding, training, or while attending doggie daycare or other function, or while on the grounds of Ventura County Dog Boarding, Lazy Dog Kennels or Ann Anderson’s residence, MGI property or any property owned or controlled by Mike Grossman or Glenn Grossman.

 

I hereby acknowledge that participation by my dogs in boarding, training, and/or doggie daycare involves an inherent risk of and exposure to property damage and/or bodily or personal injury, including injury that may prove fatal, to me, to my child, my dogs, or to others. Dangers involved include, but are not limited to: DOG BITES, death, illnesses, heat related illnesses, musculoskeletal injuries (sprains, strains, bruises, fractures, puncture wounds, etc.), stings/bites, and cuts/ lacerations, theft, fire, and lost dogs. I fully assume all risks of loss, injury, sickness, or death to me, my family, and/or my dogs associated with participation in the above stated voluntary activity and I fully consent to my dogs’ participation. I hereby consent that RELEASEES have authority to bring my dogs to any veterinarian if RELEASEES deem that medical attention is needed. I further agree and acknowledge that I am fully liable for all veterinarian expenses incurred on behalf of my dogs and that I will be billed directly by the veterinarian or reimburse RELEASEES for any and all expenses. I understand that if my dog(s) excessively barks that spray bottles and bark collars may be used on my dog. For the sole consideration of RELEASEES’ allowing my dogs to board, train, and/or participation in doggie care, I hereby waive, release, forever discharge, hold harmless, covenant not to sue, and indemnify RELEASEES from any and all liability, claims, damages, demands, rights, and causes of action of whatever kind, arising from or by reason of any personal injury, property damage, lost dogs, or the consequences thereof, resulting from or in any way connected with my dogs’ participation in training/doggie care/boarding, including theft or fire. I understand that this Agreement shall be effective every time my dogs participate in training, boarding and/or doggie care at Ventura County Dog Boarding, Lazy Dog Kennels or at Ann Anderson’s residence or MGI or property owned or controlled by Mike Grossman or Glenn Grossman. I understand and agree that anti-bark collars may be used in the event that my dogs excessively bark and that RELEASEES shall have sole discretion in placing an anti-bark collar on my dogs. If I do not pick up my dogs by the date promised then I understand that my dogs will be considered abandoned and will be turned into the humane society.

 

I expressly agree that my dog(s) may be kept in the same kennel with other dog(s) and kept in the same areas with another dog(s). Pick up of dogs must be completed by 6:00 pm – no exceptions. If I pick my dogs up earlier than planned I will receive a credit toward my dogs’ next stay. No refunds are given because other dogs may have been turned away based upon my reservation.

 

I acknowledge and represent that I have fully informed myself of the contents of this Agreement, that I freely and voluntarily sign this Agreement, and that it is my express intent that this Agreement shall contractually bind my heirs, executors, administrators, and assigns, as well as myself. I acknowledge and represent that it is my express intent that this Agreement shall be contractually binding upon me and the above each and every time I train/board/attend doggie daycare with my dog(s), including any new dog(s) I may acquire or any dog(s) I allow to be trained/boarded/attend doggie daycare.

Dated: December 8, 2022


First Dog Owners Name

First Name*

Last Name*

Phone*
First Dog Owners Date of Birth*
I certify that I am 18 years of age or older
First Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
First Dog Owners Signature*
Second Dog Owners Name

First Name*

Last Name*
Second Dog Owners Date of Birth*
Second Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Third Dog Owners Name

First Name*

Last Name*
Third Dog Owners Date of Birth*
Third Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Fourth Dog Owners Name

First Name*

Last Name*
Fourth Dog Owners Date of Birth*
Fourth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Fifth Dog Owners Name

First Name*

Last Name*
Fifth Dog Owners Date of Birth*
Fifth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Sixth Dog Owners Name

First Name*

Last Name*
Sixth Dog Owners Date of Birth*
Sixth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Seventh Dog Owners Name

First Name*

Last Name*
Seventh Dog Owners Date of Birth*
Seventh Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Eighth Dog Owners Name

First Name*

Last Name*
Eighth Dog Owners Date of Birth*
Eighth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Ninth Dog Owners Name

First Name*

Last Name*
Ninth Dog Owners Date of Birth*
Ninth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Tenth Dog Owners Name

First Name*

Last Name*
Tenth Dog Owners Date of Birth*
Tenth Dog Owners Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Dog Owners Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

DOG CARE INFORMATION


1ST DOG'S NAME:

1ST DOG'S AGE:

BREED OF DOG:

2ND DOG'S NAME:

2ND DOG'S AGE:

BREED OF DOG:

3RD, 4TH, 5TH, 6TH, ETC. DOGS NAMES

VET NAME & OFFICE ADDRESS:

VET'S PHONE NUMBER:

IS YOUR DOG SPAYED OR NEUTERED:

DOES YOUR DOG JUMP FENCES:

DOES YOUR DOG ESCAPE:

DOES YOUR DOG GET ALONG WITH OTHER DOGS:

IS YOUR DOG UP TO DATE ON KENNEL COUGH VACCINATION:
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!