Registration Form Owner InformationName of Owner*Co-ownerEmail 1* Email 2 Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneWork PhoneWork Phone ExtCell Phone 1Cell Phone 2May we contact you via text message?*YesNoIf so, please list cell phone number:*Emergency Contact (you may list up to 5):Click + sign to add more.*Emergency ContactEmergency Phone Pet InformationPet's Name*Pet's Breed*Colors/Distinct Markings*Sex*MaleFemaleSpayed/Neutered*YesNoAge Spayed/Neutered*Veterinarian name/clinic*Vet Phone*Pet’s Date of Birth* Age when obtained*From where?*Pet's Weight*What kind of food do you feed your pet?*How much do you feed?*Frequency?*Does pet have any allergies?*YesNoPlease Identify Allergies*Any illness, skin disorder, cuts or lacerations in the last 6 mths?*YesNOExplain Issue*Does pet have any physical disabilities that may affect training?*YesNoDoes pet have any chronic medical conditions or allergies?*YesNoExplain chronic medical condition or allergy*Is pet currently on any medications?*YesNoExplain Medications*Is pet crate trained?*YesNoIs pet sensitive/fearful of anything?*YesNoExplain Sensitivity*Registration InformationHow did you hear about J.M. Pet Resort?*What are you registering for today?* Obedience Training Private Lessons Daycare Boarding Grooming Are you interested in other services that J.M. Pet Resort offers? J.M. Pet Vet – Veterinary Clinic Motivational Training Private Lessons Daycare Boarding Grooming Pet Taxi J.M. Pet Resort Policies and Waiver, Assumption of Risk and Agreement to Hold HarmlessI hereby waive and release J.M. Pet Resort, its’ employees, owners and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but not without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of any such damage or injury while attending any function of the Facility, or while on the grounds or the surrounding area thereto.* I agree In consideration of, and as inducement to, the acceptance of my application for membership in obedience training class, boarding at this Facility, or doggie daycare attendance, I hereby agree to indemnify and hold harmless, this Facility, its employees, owners and agents from any and all claims by any member of my family or any other person accompanying me to any training session or function of the school or while on the grounds or the surrounding area thereto as a result of any action by any dog, including myown.* I agree I understand that when I sign up and pay for an obedience class that it takes an available limited space for a prospective guardian/dog team and that because of this there are NO REFUNDS on obedience classes.* I agree I understand that attendance at a dog obedience training class is not without risk to myself, members of my family or guests whom may attend, or to my dog, because some of the dogs to which I (we) will be exposed may be difficult to control and maybe the cause of injury even when handled with the greatest amount of care. I hereby agree to indemnify and hold harmless this school, its employees, owners and agents from any and all claims by any member of my family.* I agree I understand that obedience classes at J.M. Pet Resort are for the sole purpose of teaching me to better train my own dog basic on and off-leash commands. I understand that no canine is 100% predictable or perfect. I understand that these techniques are only effective when reinforced on a consistent basis and thus, I realize that even with training, unpredictable conduct may occur without warning. I understand that any harm my dog may inflict on any person or animal during and after a training session, or at any time in the canine's life is not the responsibility of J.M. Pet Resort. I agree to indemnify and hold harmless this school, its employees, owners and agents from any and all claims by any member of my family.* I agree I understand that in the case of illness or injury to my dog while in the care of this Facility with or without my presence, I hereby permit J.M. Pet Resort and its agents to seek treatment. I understand that I am solely responsible for payment for any veterinary care provided to my dog by a qualified treatment facility. I also understand that J.M. Pet Resort primarily uses J.M. Pet Vet - Veterinary Clinic and Brockton Animal Hospital for any care rendered to the animals in our care, and any designated 24hr. pet care facility for after hours care. I give consent for my credit card on account to be used for such same.* I agree I understand and agree that I am solely responsible for the payment of all medical bills for my pet, including those incurred at J.M. Pet Vet and/or Brockton Animal Hospital and/or any designated 24 hr. pet care facility for after hours care. I also understand that I release J.M. Pet Resort, its owner and employees, of and from any and all responsibility for, or claims, damages, debts, arising out of or related to such medical care, including J.M. Pet Vet, also including, but not limited to, transportation to/from owner’s specified veterinarian clinic, and the care rendered.* I agree I understand that if I leave my dog beyond the scheduled stay, I am responsible for full payment of any and all additional boarding and care. I understand that upon exceeding the scheduled stay by 10 days or more, I have abandoned my dog, and J.M. Pet Resort has full authority to care for and place the dog as the Facility sees fit. This includes but is not limited to: adopting the dog out, surrendering the dog to an animal shelter for adoption or attention as that shelter deems necessary.* I agree Boarding Reservations: I understand that we require 48 hrs. notice for a cancellation for any peak rate booking and a 24 hour notice for non-peak rate booking. A cancellation made prior to these designated times will incur a $25 non-cancellation fee.* I agree I understand that J.M. Pet Resort has the irrevocable and unrestricted right to utilize or publish photographic or video images of my pet for marketing and promotional purposes, without expectation or compensation. All such images remain the sole property of J.M. Pet Resort.* I agree I understand that there is a 2% late fee assessed on outstanding balances every month over 30 days.* I agree I understand that it is required to have a current credit card on file with J.M. Pet Resort to be used in the following instances: if there are any veterinary bills during my pet's stay, if there are any unpaid balances and/or late fees on those balances, if I abandon my pet, and if non-cancellation charges apply. Effective every Monday, all charges accrued for Daycare Service, Pet SittingandRetailProductsfortheweekprior,willbechargedtothecreditcardwehaveonfileforyou. Allexpensesrelatedto J.M. Pet Vet, Grooming, Boarding, and Training (or at the time of booking for Training) are due and payableuponreceiptofservice. IfweareunabletoprocessyourcreditcardonMondayforreasons beyond our control, a $15 surcharge will be implemented.* I agree I understand that I am responsible to update any and all personal information and information regarding my pet as it changes.* I agree Collars and Identification: All dogs boarding or attending daycare must have a properly fitted flat collar with identification. Collars and tags are the owner's responsibility.* I agree Personal Belongings: Toys, blankets, beds, etc. are welcomed. However, owners should be aware that we do have and provide blankets or bedding. There is NO GUARANTEE that we will be able to return items if you so choose to bring your own. Note: While your pet is staying with us, he or she will be playing in a natural, outdoor play area and your dog may get dirty. We highly recommend grooming services, such as a brush-out or bath before they go home.* I agree Meals: We strongly recommend that all owners bring their beloved pet's regular diet as to not upset their normal eating habits and digestive system. We will serve a bland diet to anyone who does not prepare meals at a $1.50 per meal charge. PLEASE DO NOT BRING BOWLS. We have special bowls that can be sterilized.* I agree Medications, Insulin Shots, Medical Treatments: There is a fully qualified technician on every shift to accommodate any of these needs. Administering medications range from $2.00 to $5.00 per treatment. All prices are subject to change based on difficulty measures.* I agree Vaccinations: No exceptions! All puppies 5 months and younger must have proof of at least 2 DHLPP vaccines and a canine cough vaccine at least 10 days prior to admission, and both initial canine bivalent influenza vaccines. All dogs 5 months and older must have proof of a current DHLPP, CIV, Rabies and semi-annual (every 6 months) canine cough vaccine. We also strongly recommend that your pet receive the Leptospirosis vaccine.* I agree Fleas, Ticks and Parasites: All dogs and cats that play and board at J.M. Pet Resort must be flea, tick and parasite free. Thus, any pet that is seen with any of the fore-mentioned problems will be treated at the owner's expense.* I agree Injuries: The Staff at J.M. Pet Resort makes every effort to be certain that the dogs here are safe in playgroup. We require temperament tests and we match personalities, level of energy and ages in our groups. The playgroup attendants are skilled at watching body language and interrupting play times before any problems ever occur. We employ time outs when need be and will sometimes have to pull dogs that are having a bad day all together. A doggie daycare is not unlike a child's daycare in that accidents do sometimes happen (fall off of the slide, another child pokes another child in the eye, etc.). Even with the utmost care and watchful eyes, dogs can sometimes nip or bite or scratch as they play with their mouths and paws. So what happens when an injury occurs? Each owner is responsible for his or her own dog. Of course, we do EVERYTHING we can to avoid problems but they are all here to have fun, wrestle and run around and sometimes play gets out of hand. We feel that the benefits of exercising and socializing your dog(s) outweigh the drawbacks of the occasional scratch or bite that may occur. This is much like the occasional knee skinning from rollerblading with a child or raspberry from sliding into home plate. It's all in good FUN.* I agree By Signing Below, you are indicating your agreement of the terms hereof in this agreement every time you visit J.M. Pet Resort. You agree to release J.M. Pet Resort, its employees and owners, customers and animal owners of any and all liability of injuries to yourself and your pet. You also understand that any and all veterinary care that may arise from a dog-dog interaction, any illness or any other injury that may occur is solely your responsibility. We agree to provide you beloved companion with the professionalism, care and love that they deserve. We look forward to your patronage.Date* Print Name*Owner's Signature*Would you like to subscribe to any of the following? Occasional J.M. Pet Resort & J.M. Pet Vet Newsletter CommentsThis field is for validation purposes and should be left unchanged.