Waiver
Should it become necessary, I hereby grant permission to Indian Cove Farm Kennel to obtain emergency veterinary care for my pet, at my expense.
I understand there is always a possibility that my pet could be injured and accept this risk at my own expense.
I will not hold Indian Cove Farm Kennels responsible for any injury that my pet(s) may incur.
| Signature | Date |
|---|
Client and Pet Information
| Dog´s Name: | |
|---|---|
| Arrival | Departure |
| Breed: | Date of Birth: |
| Male or Female? | spayed/neutered |
| Name: | |
| Address: | |
| Phone Numbers: | |
| Feeding information: | |
| Veterinary: | Phone: |
| Medicine information: | |
Vaccination Records must be current and in hand or emailed prior to visit.
Send Completed Form To:
| Fax: | 540.348.6293 |
|---|---|
| Email: | Send email to us |
