Please enable JavaScript in your browser to complete this form.Customer InformationName *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMain Phone *Additional /Alternative PhoneEmergency Phone NumberPet InformationPet's Name *Breed *Weight *Description and dispersion feeding instructions and notes *Pet's NameBreedWeightDescription and dispersion feeding instructions and notesPet's NameBreedWeightDescription and dispersion feeding instructions and notesPet's NameBreedWeightDescription and dispersion feeding instructions and notesPet's NameBreedWeightDescription and dispersion feeding instructions and notesVet InfomationOffice NameNameFirstLastPhoneAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat we agree to in perpetuity *Groomers Direct (GRD) agrees to exercise reasonable care for the pet delivered by the Owner to it for boarding. It is expressly agreed by Owner and GRD that GRD’s liability shall in no event exceed the lesser of the current chattel value of a pet of the same species per animal boarded. The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of the GRD including damage done to bedding or kennels..Groomers Direct does not assume and shall not be held responsible for any liability with respect to the pet or pets listed in this agreement. Liability, of any kind whatsoever, arising out of or from the boarding of this pet, or any damages which may accrue from any other cause whatsoever, including loss by fire, theft, disease, running away, death, injury to persons, weather, animals, or property, or death or injury to any other animal caused by the within named pet during the term of this contractOwner agrees to pay to GRD the agreed amount per pet per day for boarding service in effect on the date pet is checked into the GRD (as posted in office, and as indicated on the contract). Owner agrees to provide food in adequate amounts to cover the pets stay and agrees to pay a surcharge to be determined by the GRD for purchasing food if amount provided at drop off is inadequate. Surcharge will include cost of food, travel charge and hourly rate of $25 for whatever time it takes to obtain prescribed food. This charge will apply each individual time GRD obtains food. Owner further agrees to pay all costs and charges for special services requested, and all veterinary costs for the pet during the time said pet is in the care of the GRD. Owner is required to pay full amount of estimated boarding costs based on pickup date.Owner further agrees that the pet shall not leave the kennel until all charges are paid to GRD by Owner. Any balance that is more than 20 days past due will result in the GRD finding placement for the dog and legal action to obtain all monies due, penalties and legal fees which owner agrees to pay in full. At no time shall past due amount exceed $200.00By signing this Contract and leaving this pet with GRD, Owner or Agent certifies to the accuracy of all information given about said pet on contract above.I authorize Groomers Direct to make use of my dog’s/cat’s picture and name on/ in: The website and any brochures and advertising and live video feed of GRD. I understand that NO compensation for these pictures and information will be given or is expected by the Owner. Groomers Direct shall have complete ownership of the pictures and website usage, ads or for sale. I give GRD the right to use my dog’s name, likeness for any reason or use in whole or in part at their discretion and understand that I, the Owner, any heirs or estate will not be given or receive any compensation in any form or in any manner including but not limited to photographs of my dog(s)/cat(s) and record her/his bark/meow and likeness for the purpose of the website and/or brochures mentioned above, whether by film, videotape, magnetic tape, digitally or otherwise; make copies of the photographs and recordings so made; use my dog’s/cat’s name and likeness for the purposes of education, promotion or advertising of the sale or trading in the photographs, recordings and any copies so made. I further understand the master images in digital form or on film or video remain the property of Groomers Direct and that there will be no restrictions on the number of times that my dog’s/cat’s name and likeness in whole or in-part maybe used. (This is required for boarding.)TO THE MAXIMUM EXTENT PERMITTED BY LAW, OWNER (A) HEREBY RELEASES GRD, ITS OFFICERS, DIRECTORS, SHARE HOLDERS, EMPLOYEES AND AGENTS, FROM ANY AND ALL LIABILITY FOR ANYINJURY OR ILLNESS SUFFERED BY HIS OR HER PET WHILE IN GRD CARE, including TO THE EXTENTSUCH ILLNESS OR INJURY IS THE RESULT OF Mr. Pet Pro Groomers Direct & Pro Pet Photography’s OR PETHOST’S NEGLIGENCE AND (B) AGREES NOT TO INITIATE ANY LEGAL PROCEEDINGS AGAINST GroomersDirect OR PET HOST WITH RESPECT TO SUCH RELEASED CLAIMS.OWNER WILL INDEMNIFY, DEFEND AND HOLD HARMLESS Groomers Direct, ITS OWNER, ITS OFFICERS,DIRECTORS, SHAREHOLDERS, EMPLOYEES AND AGENTS, AND PET HOST HARMLESS FROM ANDAGAINST ANY AND ALL LOSSES, LIABILITIES, DAMAGES, FINESOwner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances and that the pet has not been exposed to distemper, parvo, rabies, or Cough within the last 30 days. In addition all Owner must provide Shot Records.ner must provide Shot Records.If pet(s) becomes ill or if the state of the animal’s health otherwise requires professional attention, the GRD, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the animal, and the expenses thereof shall be paid by the Owner.Any and all additional charges incurred by Owner shall be payable upon pick-up of pet no exceptions! GRD shall have, and is hereby granted, a lien on the pet or pets for any and all unpaid charges resulting from boarding pet at the GRD. The Owner hereby agrees that in the event the boarding charges are not paid when due in accordance with this contract, then GRD may exercise its lien rights upon ten days Written notice given by GRD to Owner by certified mail to address shown on contract. GRD may dispose of pet for any and all unpaid charges, at private or public sale or place pet with shelter, in the sole discretion of the GRD, and Owner specifically waives all statutory or legal rights to the contrary. If such sale shall not secure a price adequate to pay such costs of board or other charges delinquent, plus costs of sale, then Owner shall be liable to GRD for the difference. All monies realized by GRD at such sale, over and above the charges due and costs of sale, shall be paid by GRD to Owner.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 the Owner and GRD for this visit and for all subsequent visits.Any controversy or claim arising out of or relating to this contract, or the breach thereof, or as the result of any claim or controversy involving the alleged by any party to this contract, at the digression of the GRD will either be settled in a Court of Law or shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator or Court shall, as part of his award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.I clam no special knowledge in stipulations within this agreement and it is agreed to in perpetuity by both customer and by boarder.SignatureClear SignatureNameSubmit