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Owner Agreement
On this date ________, 20___, I ______________________the owner
of ___________________________ state that he/she/or they qualify to
participate in activities at A Dog’s Day Out (ADDO) facilities
based on the
statements I am confirming in this two page owner agreement.
1. Health & Pet ProfileI certify that my dog(s) is/are: in
good health, up to date on Rabies, Bordetella, and Distemper
vaccinations, has not been sick during the last month and is free
from any communicable diseases.
2. ResponsibilityI am solely responsible for any harm my dog(s)
cause to: another dog, ADDO employees, guests, equipment, or ADDO
property.
3. RepresentationI recognize that ADDO & their staff have
agreed to accept my dog(s) for care based upon the information I
provided in the required Owner Agreement, Pet Profile, Emergency
Care form, and my dog’s veterinary vaccination records or current
invoice detailing required vaccinations. I am presenting my dog(s)
to ADDO as not having aggressive or threatening behavior. I further
certify my dog(s) has/ have not harmed them self, another dog, or
any person.
4. LiabilityI agree that ADDO & its staff will not be held
liable for any behavioral problems, health problems, or injuries
that may occur while my dog(s) is/are in the care of ADDO, or are
playing at an ADDO facility. I release ADDO from all claims of any
kind.
5. Treatment & Reasonable CareI understand there are
inherent risks involved with my dog playing in open play areas like
ADDO, even when my dog(s) are constantly supervised. These inherent
risks include but are not limited to: Scratches, broken nails, sore
or cut paws, puppy warts, kennel cough, & even behavioral
problems. In the event of an injury/ or sickness involving my dog,
it will be treated as deemed best by the staff at ADDO within their
sole discretion. I assume full financial responsibility for any
& all expenses involved in my dogs medical care. ADDO will
attempt to contact me & contacts listed on my emergency care
form. I understand that ADDO is not a veterinarian & that if my
dog takes multiple medications for any reason that I am enlisting
the help of non-medical professionals to administer my dogs
medicines, as best they can, following the directions left for
staff.
6. Right of RefusalI understand that ADDO has the right to
reject a dog that: Is/ or becomes aggressive, threatens to harm
themselves, other dogs, staff, or guests. Dogs with fleas or dogs
believed to be too sick, old, or heavily medicated for our care,
can also be refused. ADDO can refuse service to clients who: Do not
pay overdue bills, become abusive/ or become a problem for ADDO
staff or management, repetitively cancel their dogs requested
service, or do not show up for reservations on more than two
occasions.
7. Hours of OperationWe are open every day for our clients.
Monday through Friday 7am – 7pm, Saturday 8am – 5pm, Sunday 10am –
5pm.
____________ _________
Client Initials Date
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8. Photos, Videos & RecordingsI hereby give ADDO full
permission to use videos, photos, recordings, or any likeness of my
dog(s) for any company materials without receiving any compensation
for its use & without any dispute. By entering into an ADDO
facility, I understand that a photo, video, recording, or likeness
of me with my dog(s) can also be used by ADDO without receiving any
notice, compensation, & without any dispute. I further release
to ADDO all my rights or claims that I have, for myself & my
dog(s), to any photos, videos, recordings, or likeness, etc.
9. Payments & FeesPrices & discounts are subject to
change. Paid reservations ensure your dog’s space at ADDO. The ADDO
hours of operation & pricing listed on our website
www.adogsdayout.com takes precedence over all other
company documents. ADDO offers a 33% discount on the 2nd – 4th
family dogs, after the 1st (daycare & boarding only).
Pre-arranged early drop offs are $10. ADDO will impose a $10 late
fee for dogs picked up after regular business hours (up to 30
minutes after close). Daycare & boarding dogs not picked up
within 30 minutes of close will receive overnight care & will
be billed according to ADDO pricing, until such time that they are
picked up, during regular business hours. All ADDO services are
pre-paid or paid no later than drop off. Daycare must be paid in
full each day. Any unpaid balance of more than 14-days of service
will result in ADDO imposing a 2% interest charge per month until
the unpaid balance is paid in full. If ADDO pursues legal
proceedings to collect unpaid fees, then ADDO client will pay
reasonable attorney’s fees & costs related to collection, on
behalf of ADDO.
10. Reservations & RefundsReservations are required. Each
dog’s spot is only guaranteed once payment is received in full.
Boarding cancellations specifically for the major US Holiday’s
(Thanksgiving, Christmas, New Years, Easter/Spring Break, & 4th
of July) must occur five days before the boarding was to begin, or
five days before the actual day of that major Holiday (whichever
comes first), in order to receive a full refund. Boarding
reservations, on the four major US Holiday’s which are canceled
within five days of the boarding/ or Holiday will receive a 75%
refund. We provide refunds on daycare passes in cases where: Client
moves out of area, dog dies, or is expelled.
11. AbandonmentAny dog left fourteen days beyond planned pickup
and without payment will be considered to have been abandoned.
In order to finalize my dog’s file at ADDO, I agree to complete
& turn-in the ADDO: Owner Agreement, Pet Profile,
Emergency Care form, and my dog’s veterinary vaccination records
or current invoice detailing required vaccinations.
By signing this Owner Agreement, I understand what is required
of my dog(s). I acknowledge that I have read both
pages, and understand/ agree to the terms set forth above.
_____________________________ ___________________________
_____________
Client & Legal Dog Owner - Print Client/ Legal Dog Owner -
Signature Date
_____________________________ ___________________________
_____________
ADDO Leader - Print ADDO Leader - Signature Date
ADDO Springfield, LLC * 5425-B Port Royal Road, Springfield VA
22151 * 703-321-DOGS * (Fax) 703-764-2336 *
[email protected] 12/16
http://www.adogsdayout.com/mailto:[email protected]
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Pet Profile Date: ________ The Pet Profile is designed to help
“A Dog’s Day Out” (ADDO) understand your dog’s history/
personality/ and temperament. This
completed form must be turned-in on/ or before your dog’s first
day of daycare or boarding.
Client Information Client Name: Street Address:
Apt#: City: State: Zip Code:
Cell Phone: Work Phone: E-mail:
Alternate Contact & Phone Number:
* Emergency Contact details are covered on ADDO Emergency Care
form.
Your Dog’s Bio – Part 1 Dog Name: DOB: Sex: Weight: Breed or
Mix:
Spayed/ or Neutered? If yes, what date? What city &
state?
How did your dog come into your life (shelter/ breeder/ friend/
etc.) & how old?
Vet Info (Company & Dr’s Name) Veterinarian Phone:
Veterinarian Office Address:
Vaccination Records Date Received Next Due Date 1. Rabies
____________ ____________
2. Bordetella ____________ ____________
3. Distemper ____________ ____________
Anything else we should know regarding your dog’s
vaccinations?
* Please bring the most recent invoice from your Vet that
details the vaccinations above. We can make a copy for our ADDO
records.
Medicine Is your dog taking any medicine? ________
If yes, what medicine & how often is the dosage?
Does your dog have allergies to any food or medicine?
________
If so, what allergies does your dog have?
Feeding How many cups for AM & PM feeding? ________ Any
water mix? ________ Anything else? ______________
What pet food brand & flavor does your dog eat?
Anything else you would like to mention about your dog’s
feeding?
HealthWhat is your dog’s biggest health concern?
__________________________________________________________________________
Are there any restrictions for your dog(s)?
___________________________________________________________________________
Please circle all that your dog has experienced in recent months
& then detail below critical info you want to pass along to
us.
Seizures Surgery Sensitive Spots Infections of any kind
(ear/eye/intestinal) Illness Kennel Cough Spayed/Neutered Hip
Dysplasia
Please use the space below to detail these recent experiences in
your dog’s life. (There is additional space for notes on the 2nd
page).
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Your Dog’s Bio – Part 2
BehaviorPlease circle below the statements that describe your
dog’s habits & then detail below any further information to
pass along to ADDO.
Digs Jumps Eats feces. Fears/dislikes certain people. Has formal
training. Separation Anxiety Fears/dislikes certain dogs.
Enjoys puppies. Does not enjoy puppies. Does not like ears
&/or head touched. Goes to dog park. Exhibits fence
aggression.
Fearful/nervous about certain noises/or objects Dominant Has a
high prey drive. Likes to be pet/ brushed. Bit another dog.
Has attended dog daycare. Escape artist. Has leash aggression
Food aggressive Was bit/ attacked by another dog. Submissive
Using the space below, please provide ADDO with any specific
information you deem important, relating the behaviors described
above.
Playtime
How many days a week does your dog play with other non-family
dogs (circle one)? 0 1-2 2-3 3-4 4-5 5-7
How many times each day does your dog(s) go for a walk on-leash
with you? 0 1 2 3 4+
Training
If your dog has received formal training, was it local? Who was
the trainer/ or company?
Would you recommend them to a friend?
ADDO Feedback
How did you hear about A Dog’s Day Out (ADDO)?
If you are a referral from an existing ADDO client, please tell
us who (dog & owner if possible) recommended ADDO to you?
Which offering was most important in your decision to come to
ADDO (our staff, low price, three separate daily play groups, open
every
day, 33% discount on multi-dog families, location of facility,
our Grooming, something else)?
If you needed more space to complete your thoughts on any
questions listed above, or you would like to add something not
listed above,
please use the space below.
We sincerely appreciate you choosing A Dog’s Day Out. 12/16
ADDO Springfield, LLC * 5425-B Port Royal Road, Springfield VA
22151 * 703-321-DOGS (3647) * (Fax) 703-764-2336 *
[email protected]
mailto:[email protected]
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Emergency Care Form
With this form, I hereby give permission to A Dog’s Day Out
(ADDO) to bring my dog(s) to your veterinary facility,
should there be an emergency situation or should my dog need
medical attention of any nature.
Dog Name (List all the apply)
Sex M or F
Birth Date Breed or Mix On Medication? If no, please say no.
If yes, what medication?
I have initialed the options for Veterinary care directly below,
which I approve in my absence.
Client Initials Monetary Benchmarks Approved for Care As
Needed
$500 Limit
$1,000 Limit
“Heroic Measures” ($1,000+)
Heroic Measures is a veterinary term that can be used to include
the need for surgery.
Emergency Care - Credit Card Information
Name on Credit Card Visa
or MC
Credit Card # Exp. Date Sec
Code
* I understand my credit card will not be used, unless my dog
specifically needs medical attention in my absence.
Client & Alternate Emergency Contacts Should you have any
questions in my absence & I cannot be reached immediately,
please reach out to my emergency
contacts provided below. This list is provided to ensure
immediate medical attention is given to my dog.
Name of Contact Relation to Client Phone Alt. Phone (optional)
Email
ADDO Client Self
____By initialing this line, I am identifying that I will not be
able to be reached from / / to / / , in a
timely manner.
ADDO and this Emergency Care Form are assisting me in preventing
any delay in my dog(s) gaining medical
attention, while in the care of ADDO. To any Veterinarian caring
for my dog in my absence, please accept my
signature below to provide immediate care as needed for my dogs,
at the monetary benchmarks listed above, with my
listed payment details.
_________________________ ____________________________
_____________
Client - Print Name Client - Signature Date
ADDO Springfield, LLC * 5425-B Port Royal Road, Springfield VA
22151 * 703-321-DOGS * (Fax) 703-764-2336 *
[email protected] 12/16
ADDO-SPF-Owner-Agreement-12-16ADDO-SPF-Pet-Profile-12-16SPF-Emergency-Care-Form-12-16