Exercise My Mutt LLC. 526 Richmond Terrace, Suite 201. Staten Island, NY (718) 815- MUTT. Dear Guest,

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1 Exercise My Mutt LLC 526 Richmond Terrace, Suite 201 Staten Island, NY (718) 815- MUTT Dear Guest, Welcome to Exercise My Mutt, your choice for a safe, clean doggy daycare and truly cage-free boarding. Our goal is to make sure your pup has the greatest experience when mom and dad are away, whether it's for an afternoon or a long term stay! Exercise My Mutt was founded by a Clinical Psychologist, working closely together with an Animal Behaviorist, giving us a unique approach to canine care that no other care facility can offer. In order to ensure the proper health and safety of all of our guests, the following is required of all dogs prior to entering the play or boarding areas: [ ] Proof of vaccinations: [ ] Bordetella [ ] Distemper (DHLPP)/ Parvo [ ] Rabies [ ] Completed application [ ] Temperament test Temperament testing will substantially reduce the risk of admitting dogs with aggression issues, but sometimes problems may still arise. We do everything Page 1 of 7

2 possible to protect your dogs, our guests. In the event a problem does arise, there are always trained staff in play areas and we will swiftly and safely address issues as they occur. In the event of any injuries (to dogs) all owners will be immediately notified and if necessary, immediate medical attention will be administered. Just a quick note on collars- Every dog must have a buckle collar, and no other collars are allowed in the daycare. Our staff are more than happy to answer any questions you may have during the application process, or anytime thereafter. Sincerely, Neil B. Madero, Psy.D. Exercise My Mutt LLC Page 2 of 7

3 GUEST CONTACT SHEET Primary Contact Name: E Mail: Address: Home Phone: Cell/Other Phone: Emergency Contact Name: Relationship: E Mail: Address: Home Phone: Cell/Other Phone: Pet s info (please complete for each dog) Name: Breed: Name: Breed: Name: Breed: Weight: Age: Sex: Weight: Age: Sex: Weight: Age: Sex: Veterinarian Name: Clinic Name: Address: Phone: Fax: Page 3 of 7

4 Pet Information Owner s Name: NYC Dog License #: If your dog is not licensed, we can provide you with an application. Please initial to acknowledge you were offered an application: Pet s Name: Breed: Weight: DOB: Age: Sex: Spayed/Neutered? (if not, please contact us to discuss our policy) Color/Coat: Has s/he ever bitten anybody? (please describe what happened) Medical Information: (please provide as much detail as possible) Does your pet have any medical conditions? e.g. Seizures? Allergies? Arthritis or hip dysplasia? Any medications (please complete below)? Medication(s): Medication: Taken for? Medication schedule (time and amount): Medication: Taken for? Medication schedule (time and amount): Dog food Brand: Dog s energy level? (circle) High Moderate Low Page 4 of 7

5 Exercise My Mutt LLC Client Service Agreement Exercise My Mutt LLC will endeavor to offer only sound, safe, and responsible care for my dog(s). However, I have been told and understand the risks inherent in dog day care, including but not limited to interactions with other dogs and potential exposure to disease and parasites such as but not limited to fleas. Further, I am and will remain responsible for the actions of my dog at all times and I hereby agree to indemnify and hold harmless Exercise My Mutt LLC of any and all claims of injury, expense, costs, or damages caused by the actions of my dog while under care of Exercise My Mutt LLC. I certify that I am the sole owner of the pet(s) represented in this agreement, and that all the information given about my pet(s) is accurate. I certify that my dog(s) is in good health and has not been ill with a communicable condition in the last 30 days. Upon admission, all dogs must be free from any condition which could potentially jeopardize other guests. Dogs that have been ill with a communicable condition in the last 30 days will require veterinarian certification of health to be admitted or readmitted. I understand that there are several hundred strains of Kennel Cough, and that even if my dog(s) is vaccinated against Kennel Cough (Bordetella), there is a chance that my dog can still contract Kennel Cough. I acknowledge that Exercise My Mutt LLC reserves the right to refuse to accept a pet if at check in, it appears to Exercise My Mutt LLC (in its sole discretion), that such pet is sick or that its behavior could endanger other guests or staff. I certify that my dog will be kept on a regular flea/tick control program. I understand that any dog found to have fleas will be treated by the staff at my expense. All dogs must be non aggressive and not be food or toy protective. I certify that my dog(s) have not harmed or shown any aggressive or threatening behavior towards any person or any other dog(s). I understand that my pet will be spending time with other pets and the safety and health of all of our guests is our main concern. Previous Bite History (Please complete) To the best of my knowledge, my dog named and breed type has never bit (broken the skin of) any person and has no record with the city government or animal control of a dog attack. Initials Page 5 of 7

6 Should my pet require immediate medical attention, my pet will be transported to the nearest Veterinary Hospital. Exercise My Mutt LLC will call the emergency numbers regarding my pet's symptoms, treatment options and an estimate of additional costs. In the event Exercise My Mutt LLC is unable to reach me or my emergency contact, I will authorize care at the cost indicated below. Authorization for veterinary care (Please complete) Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached. I authorize up to the following amount: $ $ $ Unlimited Initials OR Do not administer medical treatment until specific authorization is given. Initials Exercise My Mutt LLC cannot guarantee that toys, blankets or beds will be in the same condition as brought in. Exercise My Mutt LLC discourages bringing in personal items from home. My dog(s) will be kept in control, and on leash while on Exercise My Mutt LLC property. This includes in the parking lot, during travel from the car to inside the building and vice versa, as well as within the elevator. This is for the safety of my dog. I agree to pay all costs and charges for services I request and all charges incurred shall be payable at the time of my pet s discharge from Exercise My Mutt LLC. If a balance remains for 30 days or more, my account will be referred for collection action and as a result, I will be liable for collection costs (inclusive of statutory allowable interest) and legal fees, in addition to the unpaid balance. I hereby give my permission to copyright and/or use, reuse and/or publish or post pictures of my dog in color or black and white made through any media by Exercise My Mutt LLC for use in print material, electronic media or internet usage for use in advertising Exercise My Mutt LLC. This contract contains the entire agreement between the parties. All terms and conditions of this contract shall be binding on the heirs, administrators, personal representatives and assigns of Exercise My Mutt LLC. This contract is binding for all services by Exercise My Mutt LLC. * I hereby acknowledge that I have read and understand the above and agree. Pet owner Date Pet(s) Name(s) Management Representative, Exercise My Mutt LLC Date Page 6 of 7

7 526 Richmond Terrace Suite 201, Staten Island, NY MUTT ExerciseMyMutt.com PRICE LIST Standard Rates Full Day $30 Up to 13 hours (7AM 8PM) Half Day $ hours Additional dogs per family $10 for full day $5 for half day Package Rates Day Rates 5 days $135 (good for 30 days) 10 days $270 (good for 60 days) Monthly $750 (good for the Month) Boarding $57 per night $55 per night (for 3 nights and over) Training Group Classes four weeks $100 Private Training four week class $250 Puppy Socialization Class four Weeks $100 Page 7 of 7

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