Client Information

Name: ____________________________________________________________________________________________________

Address: ___________________________________________________________________________________________________

Phone #:_________________________________________ Phone #:___________________________________________________

Alternate #:_______________________________________ Email:_____________________________________________________

Garage Code: _______________________   Keys supplied ________    Alarm Code: _____________

Alarm Company: ____________________________________________________________ Phone #:_________________________

Pets

Name: ________________________________________   Type of Animal: ______________________________________________

Name: ________________________________________   Type of Animal: ______________________________________________

Name: ________________________________________   Type of Animal: ______________________________________________

Name: ________________________________________   Type of Animal: ______________________________________________

Please read and initial the following statements:

_______ I hereby give permission to Your Place or Mine Pet Sitting and its affiliates to enter my home for the purpose of caring for my pets.

_______ I hereby give permission to Your Place or Mine Pet Sitting to use any pictures taken of my pets for promotion or marketing  purposes.

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I agree to the rate of:

$______/ visit                $______/ day lodging                $______/ day sleepover                $______/ hour

Signature:__________________________________________                Date:________________________________