Drop-In Consent Form

Owner's Name

Phone Number

(###)

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Alternate Contact

Alternate Phone Number

(###)

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Vet Clinic

Address

Phone Number

(###)

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Start Date

YYYY

End Date

YYYY

Number of Visits Per Day

I give permission for my pet's photo to be used on Kali's Cottage Pet Boarding's social media, including kaliscottage.com, Facebook, and Instagram.

Yes

If my pet(s) should become ill while in the care of Kali’s Cottage, the following veterinary practices have permission to provide medical treatment as necessary:

The above mentioned veterinary practices may provide medical treatment with fees not to exceed:

I understand and agree that Kali’s Cottage will not be liable for any problems that develop provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind arising from my pet(s) attendance and participation at Kali’s Cottage. I certify that my pet(s) appears to be free of contagious disease and has not bitten anyone in the past ten days. I accept that if I fail to pick up my pet(s) within ten days, it will be considered abandoned and will be handled in accordance with state law, and that doing so does not relieve me of my financial obligations. I have read and understand the information on the Requirements, Rates, and appropriate Services pages.

Electronic Signature

First Name

Last Name