EmailMe Form - Gatehouse Bed & Biscuit

Name of Owner

First Last

Name of Co-owner (if any)

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email

Phone

### - ### - ####

Emergency Contact

Phone

### - ### - ####

Call Name of Dog

Breed

Age (DOB)

Intact or Altered *

Veterinarian Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Vaccinations

Medication

Flea/heartworm

Other (specify below)

Food

Kibble (detail brand and amount below)

Raw (detail brand and amount below)

Please outline your dog's feeding schedule and amount fed.

Please outline your dog's medication amount and schedule.

A bit about your dog

Did you get your dog as a puppy or adult?

How long have you had your dog?

Boarding Contract
Gatehouse Kennel Bed & Biscuit ("Kennel") agrees to exercise reasonable care of the Owner's dog(s) ("pet"). The pet will be cared for without liability on the Kennel's part for loss, damage due to fire, theft, escape, illness, injury or harm to pet. The parties agree any legal action will be commenced in the County of Grey, Province of Ontario. All charges are due to the Kennel upon pick up of the pet. Should the pet become ill or otherwise require veterinarian attention, the owner agrees the Kennel may engage the service of a veterinarian of its choosing or administer medicine at the owner's expense. Any pet not picked up by two weeks after the agreed upon pick up time shall be considered abandoned and will be rehomed or placed with the Humane Society. Cancellations require 24 hours notice or one day charge will apply.
Please Print Name, Sign and date below

Photo Release
Permission to Use Photographs
I authorize Gatehouse the right to use and publish in print or electronically any photographs of my pet with or without my name for any lawful purpose, including as publicity, illustration, advertising and web content.
Please sign and date below