Owner & Dog Information
Please acknowledge the following policy statements by typing your initials the boxes provided. If you do not agree to all statements, please do not complete this form, and contact Stay directly for more information.
BY INITIALING BELOW, in consideration of the services rendered by STAY to my dog(s), I acknowledge reading, understanding, and accepting the statements herein.
AGREEMENT TO PARTICIPATE AND LIABILITY WAIVER I understand certain "activities" that my dog may participate in, including daycare, boarding, one-on-one play, movement within and outside the facility, and transportation to and from STAY involve risk and possible injury, including but not limited to:
I further understand that not each and every potential risk can be listed above but, nonetheless agree that the benefits associated with dog socialization outweigh the possible risks, therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify STAY and its agents, successors, heirs, from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my Dog's participation in activities at STAY, including those allegedly attributable to the negligent acts or omissions of STAY or their staff.
Further, I understand that I may be exposed to certain risks when bringing my Dog to participate in activities at STAY or when picking up my Dog from participating in activities at STAY. Such risks may include property damage and/or physical injury inside or outside the facility, such as from falling, slipping, illness, and/ or dog bites. Therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify STAY, its agents, successors, heirs from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my Dog's participation in activities at STAY, including those allegedly attributable to the negligent acts or omissions of STAY or their staff.
AUTHORIZATION OF MEDICAL CARE: If my dog is ill or injured while participating in activities at STAY, STAY will make every reasonable effort to reach me pursuant to the contact information I have provided STAY. However, if STAY is unable to reach me, I consent to STAY seeking appropriate veterinary care and I accept responsibility for any and all associated expenses. STAY will not pay any portion of veterinary expenses associates with seeking medical care for my dog if so necessary.
ALLERGIES, SPECIAL DIETS, MEDICATIONS: I agree that I will disclose to STAY any allergies my Dog may have. I further agree to disclose to STAY any special dietary needs or medications my Dog may require if necessary during activities at STAY.
PHOTOGRAPHS AND STATEMENTS: I authorize use of my dog's visual image(s) and statements in newsletters, posters, and other materials.
VICIOUS TENDENCIES: I affirm that I am not aware of any vicious tendencies by my Dog.
AGREEMENT TO PAY: STAY accepts check, cash, or credit cards. I agree to pay the service rates in effect for my dog's participation in activities at STAY. I further agree to pay for any additional services requested such as grooming, drop-off, and/or pick-up service. A valid credit card must be kept on file at all times. Charges not paid in advance will be charged to Client's credit card. All services must be paid in full before Dog will be released to Client.
Boarding: All boarding cancellations must be made 24 hours prior to check in. If a cancellation is not made 24 hours prior to check in it will be considered a "no show." Also considered a "no show" will be all instances where a dog is not checked in at all for a boarding reservation. All "no show" incidents will be charged one full day of day care.
DAMAGE: I accept the responsibility of paying for any damage to facility, property, and/or equipment caused by Dog.
VETERINARY RECORDS: My Dog's complete veterinary records must be furnished to STAY. These records must include proof of vaccinations and/or treatment for: parvovirus, distemper, Bordatella, heartworm, fleas, and ticks. Records may be sent via facsimile to: (773) 509-0050. I further attest that my dog is free of parasites and other illnesses that can be transmitted from dog-to-dog. Due to the high risk of dog-to-dog transmission of such parasites and/or viruses, I agree that I will immediately notify STAY if I learn or suspect my Dog has parasites or viruses and agree to not bring my Dog to STAY for any activities until I receive clearance from STAY, in conjunction with my Dog's veterinarian.
EVALUATION OF DOG PRIOR TO PARTICIPATION: Every Dog must be evaluated by STAY prior to participating in any activity. Such evaluation may assess the Dog's temperament and interactions with other dogs and STAY staff.
RIGHT TO DECLINE: I understand that STAY reserves the exclusive right to decline participation or to terminate participation in activities at STAY to any Dog at any time for any reason.
ATTORNEY FEES, APPLICABLE LAW & VENUE: Should STAY, or anyone acting on their behalf, be required for any reason to incur attorney fees and costs to enforce or defend this agreement, I agree to indemnify and reimburse STAY for such fees and costs. Further I agree and understand that any disputes arising out of this Agreement will be decided pursuant to the laws of the State of Illinois and venue shall be in Cook County.
VALID DATES: These agreements, waivers, and authorizations will remain valid and in force as long as and whenever my Dog participates in any activity at or with STAY.
WARNING: By signing this document, I acknowledge that if my Dog is or I am hurt or property is damaged during my Dog's participation activities at STAY, I may be found, by a court of law, to have waived my right to maintain a lawsuit against STAY on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read and fully understand this entire document and I agree to be legally bound by its terms.
I understand that before my dog(s) can play or board at Stay, the following requirements must be met:
Proof of current dog license must be submitted to Stay.
A credit card (Visa or Mastercard) is required to hold reservations with Stay.
I have reviewed and submitted this liability waiver to Stay, Inc. By clicking the Submit button below, I certify that all data I have provided and agreed to on this form is correct and truthful to the best of my knowledge.
