New Client Information Name *Email Address *Phone *Street Address *CityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweDog Name *Dog aprox ageDog aprox weightName of Veterinary Practice *Veterinarian Phone *Veterinarian Email AddressUpload proof of vaccinationChoose FileNo file chosenDelete uploaded fileDoes your your dog have any special needs that we should be aware of?Boarding contractBoarding Agreement This is a Contract between Valkin Boarding Kennel (hereinafter called "Kennel") and the pet owner whose signature appears below (hereinafter called "Owner") for services for (hereinafter called "Pet"). Payment is expected for services at the time of checkout. Owner agrees to pay the rate of $25.00 a night for boarding. Owner agrees to pay all costs and charges for special services requested, plus all veterinary expenses deemed appropriate by Kennel for Pet during the time it is in the Kennel's care. Kennel shall attempt to contact Owner before incurring such veterinary services as may be required by Pet's health and/or behavior. Kennel shall exercise reasonable care for Pet delivered by Owner to Kennel for boarding. It is expressly agreed by Owner and Kennel that Kennel's liability shall in no event exceed fair market value of a pet of the same breed or the sum of $500. 00. Owner agrees to be financially responsible for kennel property damaged by Pet. Reasonable costs for damage will be payable upon checkout of Pet. Owner specifically represents to Kennel that Pet has not been exposed to rabies or distemper within a thirty-day period prior to boarding. Kennel requires proof of current Rabies, Distemper and Bordetella vaccinations. All pets are checked for external parasites (fleas/ticks) upon entry to the facility. If any external parasites are found, they will be treated accordingly, and Owner will be responsible for those expenses. If Pet becomes ill or if Pet's behavior is endangering itself, humans, or other animals, Kennel, in its sole discretion, may engage the services of a veterinarian. All attempts will be made to contact the Owner of the Pet first; however, in the event of an extreme emergency, the wellbeing of the Pet comes first. Medication will be administered as necessary under the direction of a veterinarian. The undersigned Owner hereby gives the veterinarian complete authority to treat Pet in whatever manner deemed necessary. Owner will be responsible for all veterinary charges upon release of the Pet. Owner also gives full authority for the treating veterinarian and their associates to discuss with Kennel any aspect of any illness or injury that the Kennel has presented for treatment. Owner authorizes Kennel to use pictures of their Pet taken while participating in Kennel activities on its website and in other promotional materials. By initialing this Agreement and leaving Pet with the Kennel, the owner indicates that he or she has read and accepted all policies listed in this agreement. Owner certifies to the accuracy of all information given about Pet to the best of their knowledge. Owner specifically represents that he or she is the sole owner of Pet.Please initial here *0 / 5Send Message