Boarding Release Form

I am the owner or agent for the pet mentioned above and I have the authority to execute this consent. I authorize the veterinary staff at Main Street Veterinary Clinic to treat my pet if it should become ill while boarding until I can be reached and to do whatever is necessary should an emergency situation arise. I understand that medical supervision is available during normal office hours. I authorize outdoor leashed walks for my pet and exercise in a fenced yard. I understand that any examination, bath, vaccines, special handling charges, etc are at additional cost to me and are subject to change without prior notice. I have read and I understand the policies stated above and understand that payment is due at the time of pick-up.

I, the undersigned client, hereby give my consent for my pet (named above) to be boarded at Main Street Veterinary Clinic (MSVC) on the above mentioned dates. I acknowledge that I have received and read MSVC's notice on its lack of fire suppression and overnight staffing. I understand and acknowledge that MSVC is not equipped with an on-site fire suppression sprinkler system. I further understand and acknowledge that MSVC is unstaffed between the hours of 6pm and 7am during the week and most of the hours on the holidays and weekends. I understand that my pet will be left unattended during those times and during their boarding stay.

By signing this consent form, I agree to release MSVC, its owners, employees and agents from any and all liabilities, claims and/or expenses that may arise from my pet's boarding stay, including but not limited to injuries, illnesses or death. I have read and understood the statements outlined in the notice and in this consent form and release. I voluntarily consent to my pet staying/boarding at MSVC and acknowledge that I am solely responsible for any consequences that might arise during their stay.