Hospitalized Boarding Consent and Release Form

REQUIRED NOTICE: LACK OF FIRE SUPPRESSION AND OVERNIGHT STAFFING

Boerne Veterinary Clinic, as is allowed by Texas law, is not equipped with an on-site fire suppression sprinkler system and does not employ on-site personnel during our open hours. All animals boarded at the Facility will be left unattended during those times.

OWNER CONSENT AND RELEASE FOR DOG OR CAT TO BE LEFT UNATTENDED DURING HOSPITALIZED BOARDING

Client Name *

First

Last

Client Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

E-mail

Pet's Name *

Breed *

Age *

Weight *

Veterinarian *

Veterinarian Phone *

I hereby give my consent for my pet named above to be boarded at the Facility on the following dates below. *

I agree and understand.

List Dates *

I acknowledge that I have received and read the Facility's notice on its lack of fire suppression and overnight staffing. Iunderstand and acknowledge that the Facility is not equipped with an on-site fire suppression sprinkler system. Ifurther understand and acknowledge that the Facility is unstaffed between the hours specified in the notice and that my pet will be left unattended during those times during their boarding stay. *

I agree and understand.

By signing this consent form, Iagree to release the Facility, its owners, employees and agents from any and all liabilities, claims or expenses arising from my pet's boarding stay, including but not limited to injuries, illnesses or death. *

I agree and understand.

I have read and understood the statements outlined in the notice and in this consent form and release. I voluntarily consent to my pet staying at the Facility and acknowledge that Iam solely responsible for any consequences that might arise during their stay. *

I agree and understand.

Client Signature *

Date *

Name