HALO Boarding Agreement
Email address *
Name *
Your answer
Dog's name *
Your answer
Address *
Your answer
Home phone number *
Your answer
Cell phone number *
Your answer
Email address *
Your answer
Boarding dates (to-from) *
Your answer
Drop off time *
Time
:
Pick up time *
Time
:
Type of food *
Allergies *
Your answer
Food restrictions *
Your answer
Frequency *
Medications *
Your answer
Last dose given *
Your answer
Frequency *
Special instructions for medication *
Your answer
Is your dog/cat good with children? *
Is your dog/cat good with other dogs? *
Is your dog/cat good with other cats? *
Does your dog/cat have any behavior issues? *
If yes, please explain *
Your answer
Should your pet require immediate medical attention, your pet will be transported to the nearest Veterinary Hospital. We would call the emergency numbers regarding your pet's symptoms, treatment options and an estimate of additional costs.Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached. I authorize up to the following amount: *
By typing my initials below, I agree to the amount checked above, in the event of an emergency. I also agree that by typing my initials, that this is a legal and binding digital signature. *
Your answer
Do not administer medical treatment until specific authorization is given. *
By typing my initials below, I request that no medical treatment be given (in the event of an emergency), until specific authorization is given by me. I also agree that by typing my initials, that this is a legal and binding digital signature. *
Your answer
It is the responsibility of the client to provide proof of vaccination history for each animal attending HALO (Helping Animals Lost and Orphaned). Dogs whose shots are not up to date will not be allowed to attend. To ensure the protection of all the pets under our care, the following vaccinations must be up to date 5 days prior to attendance.Rabies, Distemper, Bordetella, DHLPP – 6 month vaccination. Owner understands that even if Owner’s dog(s) is vaccinated against Kennel Cough (Bordetella), there is a chance that the Owner’s dog can still contract Kennel Cough. I agree that I will not hold HALO (Helping Animals Lost and Orphaned) responsible if Owner’s dog(s) contract Kennel Cough.
By typing my initials below, I agree to the above vaccination policy. I also agree that this is a legal and binding digital signature *
Your answer
Disclaimers & Additional Provisions Relating to Day Care and Group Play
HALO is happy to offer the opportunity for your dog to use the facilities
and participate in group play. HALO offers an indoor play areas where all
dogs will be under supervision by one of our staff.
Group play is an important part of a dog’s ability to socialize and obtain exercise to maintain a healthy heart and weight. In order for us to be able to offer these valuable services, we have developed the following set of provisions and disclaimers, which you must carefully read and agree to the following before allowing your pet to participate in group play or day care activities at HALO:
(1) Group play is for happy, healthy dogs that are neutered or spayed. Play group is not recommended for dogs that have medical conditions such as diabetes, seizures, heart murmurs or any other medical condition that may be aggravated by excitement or rough play. HALO assumes no responsibility for the aggravation of any medical disorders.

(2) Group play is also not for dogs that have temperament problems such as aggression or extreme shyness with either dogs or people. If your dog is found to exhibit any of these behaviors they will be removed from the playgroup and you will receive a note with an explanation as to why your dog was removed. HALO has a no tolerance policy. The daily fee will not be refunded for this day of daycare.

(3) Standard precautions will be used against the injury, escape, or death of this pet. The clinic and staff will not be held responsible for injuries that occur, provided standard care and precautions have been followed as determined at the sole discretion of HALO. In no event shall HALO be liable for illnesses that arise during Owner's pets stay or after Owner's pet has left the facility.

(4) Owner understands and agrees that the Owner is solely responsible for any harm caused by Owner’s dog(s) while attending HALO. Owner further
understands and agrees that in admitting Owner's dog to HALO all
health and behavior problems have been fully disclosed to the best of owner’s
knowledge.
(5) HALO reserves the right to refuse to accept a pet if at check- in it
appears to us, in our sole discretion, that such pet is sick or that its behavior could jeopardize the health or safety of other pets or our staff.
(6) Owner agrees and understands that there are inherent risks of illness or injury when dealing with animals and humans in a group situation. Such risks include, but are not limited to: problems associated with rough play such as bite wounds and scratches, kennel cough or other illness, and in rare instances death. Owner understands and agrees that under no circumstances shall HALO be responsible for illness or injury to pets.
(7) Owner fully understands that any health or behavior problems that develop during their stay at HALO will be handled and treated as deemed appropriate by the employees at HALO and owner agrees to assume full financial
responsibility for any and all expenses arising or relating thereto, subject to the
stipulations set forth in the Medical / Illness policy above.
(8) A late fee of $2.00 will be incurred for pickups outside of the scheduled time. If late pick up becomes a common occurrence, HALO has the right to raise fees at own discretion.
(9) All charges incurred by the Owner under this agreement shall be due and payable in full upon pick up of the pet. Owner agrees that the pet shall not leave HALO until such time as all charges incurred by the Owner have been paid in full to HALO.
(10) This contract is subject to the provisions of Ohio Code 959.01 (Abandonment of Animals), which reads: No owner or keeper of a dog, cat, or other domestic animal, shall abandon such animal.
(11) 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 Owner and HALO.
(12) If any legal action is brought to enforce the provisions of this contract, the prevailing party shall be entitled to recover reasonable attorney's fees. These fees, which may be set by the court in the same action or in a different action brought for that purpose, are in addition to any other relief to which the prevailing party may be entitled. Owner agrees that venue for any action or proceeding filed under this contract shall be in Xenia, Ohio.
(13) Owner understands and agrees that in the event that any portion of this agreement shall be found void or unenforceable for any reason all other portions of the agreement will remain in full force and effect.
Cancellation Policy
Should it occur that you must cancel your booking, please do so as soon as possible.
Cancellations and no- shows that take place within 24 hours of drop off date will be charged a non – refundable daily rate.
Agreement
I have read, understand and agree to all provisions of this agreement. I fully intend to
pick-up my pet on the above specified date. If circumstances change I will notify HALO of the new pick-up time and assume responsibility for any additional charges incurred.
I understand that allowing my dog to participate in group play at HALO is
not without risk to my dog, and I accept and agree to be fully responsible for the consequences of assuming such risk. I hereby release HALO for any
responsibility for injury to my pet.
I hereby waive and release HALO and their employees and volunteers from any and all liability for injury or damage resulting from the actions of my dog, any
other dog, or any humans in the playgroups. I expressly assume the risk of any injury to my dog including any and all medical expenses resulting from or relating to said injury, subject to the stipulations set forth in the Medical / Illness policy above.
I hereby agree to indemnify and hold harmless HALO, its employees,
officers, members, agents, and guests from any and all claims resulting from any action(s) by any dog in the play group (including my dog) and that this release and indemnification shall be in force whenever my dog participates in the community playgroup starting with the date indicated below and thereafter.

By typing my initials below, I agree to the above Disclaimers & Additional Provisions Relating to Day Care and Group Play. I also agree that this is a legal and binding digital signature. *
Your answer
Initials of (Owner/Agent for pet). I agree that by typing my initials below that this is a legal and binding digital signature. *
Your answer
Printed/Typed Name *
Your answer
Today's date *
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