Connie Winters’ Kennels, Inc., The Vacation Spa for Pets   Please answer all questions completely to help us understand your pet and keep him (her) healthy, happy and safe   Or, click here to download and print the registration form.    Owner’s Name: Street Address: City, State Zip: Home phone: Cell Phone: E- Mail address: Emergency phone: Emergency contact person: Pet Information Pet’s Name: Breed /or combination: Color(s): Sex: Spayed: Neutered: Type of Pet: Date of birth: Month: Day: Year: Weight: Health problems: Vet: Medications: (must be labeled pet’s name/ dosage) Vaccination Record (give  date- must be current): DHLP-P: Bordetella: Rabies: Feline Leukemia: CCRP: Medications: Special Instructions: Labeled Possessions: Regular brand of food: Amount: Time of meal(s): What is your pet’s favorite toy?: Pet’s favorite past time?: How long is your pet alone?: Pet’s exercise schedule?: Does your pet live with: Children Dog Cat Other Only with owner Is your pet afraid of: Loud Noises Thunder/ Lightning Other Animals Men Women List of Other Fears Has your pet ever shown aggressive behavior towards: Humans Animals Please explain: Has your pet ever bitten anyone or another animal: Details: Has your pet ever shown any destructive behavior: Explain:   SPA AND LODGING SERVICES REQUESTED Deluxe Suite Lodging pkg. Standard Lodge room Bunk Bed room Breakfast in Bed Dispense Meds Day care Doggie Camp--Group Play Time Individual Extra Exercise Session Complete Spa grooming Bath and Nails Only Pedicure Flea/ Tick treatment Cuddle Time \ tummy rubs Pool Time Nature Hike Obedience Training Single Cat Room Townhouse for Cat(s) Contract Owner’s signature: Date:     Connie Winters’ Kennels, Inc., The Vacation Spa for Pets Important! Please Read Carefully! This is a contract between Connie Winters’ Kennels, Inc. and the pet owner whose signature appears below (hereinafter call “Owner”). Owner agrees to pay the rate for boarding, and other services requested, in effect on the date pet is checked into the kennel. Owner further agrees to pay all costs and charges for special services requested and all veterinary costs for the pet during the said period that the pet is in the care of the kennel. Owner further, agrees that the pet shall not leave the kennel until all charges are paid to kennel by  Owner.  By signing this contract and leaving his/ her pet with kennel, Owner certifies to the  accuracy of all information given about said pet. Kennel shall exercise reasonable care for the pet delivered by the Owner to the kennel for boarding and/or other services. It is expressly agreed, by Owner and Kennel that Kennel’s Liability shall in no event exceed the lesser of the current chattel value of a pet of the same species or the sum of $200.00 per animal boarded. The Owner further agrees to be solely responsible for any and all acts and behavior of said pet while it is in the care of the Kennel. Owner specifically represents that her or she is the sole owner of the pet, free and clear of all liens and encumbrances.  Owner specifically represents to Kennel that the pet has not been exposed to Rabies, Distemper, Parvo or Canine Influenza within a thirty- day period prior to boarding. Owner also represents to Kennel that pet has been properly and currently vaccinated by a licensed veterinarian within the guidelines of  the kennel. All charges incurred by the Owner shall be payable upon pick-up of Pet, or when billed by kennel at address listed on first page of contract. The Kennel shall have, and is hereby granted, a lien on  the pet for any and all unpaid charges resulting from boarding or other services requested by Owner. The Owner hereby agrees that in the event the boarding and other charges are not paid when due in accordance with this contract, the Kennel may exercise it’s lien rights upon ten days written notice given by Kennel to Owner by certified mail to address shown on first page of contract. Kennel may dispose of pet for any and all unpaid charges, at private or public sale, in the sole discretion of the Kennel, and Owner specifically waives all statutory or legal rights to the contrary. If such sale occurs, Owner shall be liable for the difference. All monies realized by Kennel at such sale, over and above the charges due and costs of sale, shall be paid by Kennel to Owner. If pet, becomes ill or if the state of the animal’s health otherwise requires professional attention, the Kennel, 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. 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 the Kennel. Any controversy of 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 negligence by any party to this contract, shall be settled in accordance with the rules of the American Arbitration Association, and judgment upon award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator 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. Pet Owner’s signature: Date: Connie Winters’ Kennel, Inc., Representative: