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1 The Bow Wow Barn, LLC Enrollment Form and Contract Owner Information Name Significant Other Address City State Zip Home Phone Work Cell Address Do you have a Facebook page? How did you hear about us? Radio Ad Printed Ad Facebook Friend/Acquaintance Other: Other people allowed to pick your dog up from daycare: Name: Phone: _ Name: Phone: _ Name: Phone: _ Emergency Contact Information Name Phone Relationship Vet s Name Phone

2 A copy of vaccination records and this completed form must be presented prior to the time you bring your dog(s). Your dog(s) will not be allowed to stay without proof of vaccinations for Rabies and Distemper/Parvo. The Bow-Wow Barn, LLC Policies: 1. All dogs must be friendly with both people and other dogs. 2. All vaccinations must be current. Proof of current Rabies & Distemper/Parvo is required. 3. All dogs must be healthy. If your dog is ill (diarrhea, vomiting, coughing, sneezing, etc.), please do not bring them in until your veterinarian provides written approval. 4. All payments must be made at the conclusion of services. 5. All services require a reservation. 6. All dogs will be supervised & will be invited to attend structured activities throughout the day. 7. Safety of the dogs is our first priority. Though we do everything possible to prevent incidents, dogfights can happen and can result in injury. If injuries occur, we will take your dog to the veterinarian and provide you with notification immediately. 8. This facility does not require a current Bordetella (canine cough) vaccination; however, we strongly recommend you obtain it. The Bordetella vaccination helps protect against some, but not all strains of upper respiratory infection collectively known as canine cough. Canine Cough may be contracted by a dog, even if the vaccination is current. This is the ONLY vaccine requirement we will waive with your acknowledgment by your signature below. Realize that if your dog does not have this vaccination, they are at greater risk of contracting canine cough. Dog owners are responsible for all medical expenses associated with their respective dog(s). I have read and understand all policies. Signature Date

3 Canine Profile (Please fill out 1 for each dog) Dog s Name Dog s Sex Spayed or Neutered Dog s Breed Dog s Date of Birth Dog s Age Dog s Weight How long have you owned your dog? Have you ever boarded your dog before? Is your dog house trained? Is your dog crate trained? What brand and type of food does your dog eat? How many meals per day? How many cups per meal? If your dog runs out of food while staying with us are there any restrictions on the type of food we provide? Does your dog take medications? If so, for what? How often? Does your dog have any allergies? If so, what type? Do you use flea/tick medication? If so, please list the brands, type, and date last administered. Behavior Does your dog chew on furniture or blankets? Does your dog bark a lot?

4 Does your dog have any past injuries or any current conditions? Do we need to place any restrictions on your dog s activities or any special needs that need to be addressed? Is your dog frightened by anything? What happens when you or somebody else tries to take food or toys from your dog? Does your dog share toys well? Will your dog allow you to take a toy or treat away without growling? Does your dog get along well with other dogs? Has your dog ever socialized with a large group of dogs? Please describe circumstances and your dog s behavior Does your dog have any sensitive areas on the body or areas your dog does not like to be touched? Are there any types of people that your dog automatically dislikes or fears? Is your dog aggressive on leash? Off leash? What are your dog s exercise/walk routines? Has your dog ever bitten anybody? What were the circumstances? Has your dog ever jumped or climbed over a fence? How high? Would you like your dog to interact in water play or swimming? What would you like your dog to learn or achieve by attending daycare? If you only require us to love your dog, we will do that no problem!

5 Consent for Treatment and Contract I,, acknowledge with my signature below that I have read and understand that the concept of dog daycare and kenneling is to allow for dogs to be socialized by interacting with people and dogs. This interaction is both enjoyable and extremely beneficial for the behavior of most dogs. As always, with the interaction of dogs and/or kenneling, there is a chance of injury. I assume all risks that are associated with this activity as well as any injury to my dog while at The Bow-Wow Barn, LLC, whether co-mingled with other dogs or not. I understand that, despite all the dogs appearing healthy and being handled with the greatest amount of care and foresight, participation in daycare and boarding at The Bow- Wow Barn, LLC is not without risk. Exposure to our open play environment may result in injuries including, but not limited to cuts, bites, scratches, abrasions, puncture wounds, sore paw pads, contraction of contagious diseases and/or parasites, tracheobronchitis (Canine Cough), stress, loss of appetite, behavioral issues, diarrhea, sprains, fractures, broken bones, insect bites, snake bites, allergic reactions, weight loss or gain, eye injuries, hot spots, bloat, and, in extreme situations, death. I understand every effort will be made by the Bow Wow Barn, LLC to contact me immediately in the event my dog suffers any injury. If it should become necessary for my canine to receive professional medical treatment, I hereby give my permission for a licensed veterinarian to administer the medical treatment he or she deems necessary. In the event that the medical expenses exceed $. for treatment of non-life or limb threatening injuries or illnesses, I request that a Bow-Wow Barn, LLC representative or attending veterinarian contact me before any further treatment is performed. While The Bow Wow Barn, LLC will make every effort to contact your veterinarian, in an emergency your dog will be transported to Sterling Animal Clinic; Dr. Mark Cochran DVM. I understand that I am financially responsible for any and all costs resulting from veterinary care. In the event of a life or limb threatening situation, I give The Bow-Wow Barn, LLC permission to use any available medical resources to save my dog s life, including but not limited to emergency surgery. I acknowledge the above

6 monetary limit for veterinary treatment may be exceeded if such treatment is necessary to save the life or limb of my dog. In the unlikely event that my dog passes away for any reason while at The Bow-Wow Barn, LLC, I understand that he or she will be transported to my veterinarian. If this veterinarian is not available, the pet will be transported to a veterinarian available to The Bow-Wow Barn, LLC. I agree that my dog(s) is/are in good health and I will not bring any animals to The Bow-Wow Barn, LLC if they have been ill with any communicable diseases or parasites until The Bow Wow Barn, LLC receives a written release from their veterinarian. I hereby waive and release The Bow-Wow Barn, LLC, its employees, owners, directors, officers, agents, and heirs from any and all liability of any injury, death, or loss of my dog resulting from The Bow-Wow Barn, LLC s actions, or from the action of my dog, or any other dog, while in the custody of, on the grounds of, or surrounding area of The Bow-Wow Barn, LLC, including, as a result the negligence of The Bow-Wow Barn, LLC. If my dog causes injury to another dog or person while at The Bow-Wow Barn, LLC, I agree to indemnify and subrogate The Bow-Wow Barn, LLC from any action which may be brought against it and for any defense, settlement of judgment entered against it. I will assume all liability for the actions of my dog. I have been given a copy of the policies of The Bow-Wow Barn, LLC and agree to abide by all policies and procedures. I also agree that any photographs, recordings, or other images and likenesses may be made of my dog(s) by The Bow-Wow Barn, LLC and that such may be used for any purpose without compensation to the dog owner. The dog owner hereby releases to The Bow-Wow Barn, LLC all rights that he/she may possess or claim to such images, recordings, photographs, etc. Payment is required when services are rendered. The fee schedule for the Bow Wow Barn, LLC is included in the enrollment packet and is subject to change without notice to the dog owner at any time. No-shows and cancellations of daycare without 24 hours notice prior to the drop-off time scheduled will be charged full price. If you must cancel an overnight boarding appointment for any

7 reason, we must receive notice 48 hours prior to the first day of the reservation. No-Shows and cancellations after this time are non-refundable. We accept cash, check, VISA, MasterCard, Discover, and American Express. I understand that if I neglect to pick up the above animal(s) within six days of the end of my appointment, written notification of the dog owner s intent to abandon the canine will be sent to my last known address. After two weeks have elapsed from the date of that mailing, the Bow-Wow Barn, LLC will consider the canine abandoned and it will become property of The Bow-Wow Barn, LLC. I will be charged the full boarding rate and any associated fees up to the date that we take possession of the animal. I acknowledge that abandonment of my animal does not relieve me from financial obligation to the Bow Wow Barn, LLC. I further understand that in case of nonpayment, I will be subject to all billing, finance, and or collection charges and actions associated with my account and pursuable by The Bow Wow Barn, LLC. By signing this registration form, you indicate that you are the owner, or the agent of the owner, of the aforementioned canine(s), and are authorized to release the pet to the care of The Bow-Wow Barn, LLC. You also indicate that you understand the policies, procedures, and schedule of fees as stated, and affirmatively, voluntarily, and expressly consent to the release and other terms set forth in this contract. The Bow-Wow Barn, LLC reserves the right to add, update, and change these policies, procedures, and schedule of fees from time to time without notice. Continued use of our services after any such changes shall constitute your consent to such changes. I give consent for my dog/dogs to be co-mingled with other dogs. I give consent for my personal dogs to be kenneled together If I have marked my dog is crate trained, I consent for them to be housed in a crate. I give permission for my veterinarian to release vaccination records to The Bow-Wow Barn, LLC. I understand that Bordetella (canine cough) is analogous to the human Common Cold, and that even dogs vaccinated with the Bordetella vaccine may still contract canine cough. This virus has an incubation period of 3-10 days

8 wherein the virus may be completely asymptomatic, but still contagious. The Bow-Wow Barn, LLC will make every effort to sanitize any area believed to be contaminated, and refuse any obviously sick dogs from staying with us. With that in mind, it is important to know the virus is airborne and your dog is as much as risk to acquire it here as anywhere else where dogs congregate. A copy of vaccination records must be presented prior to the time you bring your dog(s). Your dog(s) will not be allowed to stay without proof of vaccinations for Rabies and Distemper/Parvo. Owner Printed Name Owner Signature Date , v. 2