Customer (your) Name *
Customer (your) Name
Cell/Primary Phone *
Cell/Primary Phone
Secondary Phone Number
Secondary Phone Number
One dog per form please. If you have multiple dogs you will need to fill out multiple forms. Sorry for the inconvenience.
Sex *
Birthdate (approximate if you don't know) *
Birthdate (approximate if you don't know)
Vet's phone number?
Vet's phone number?
Is your dog spayed or neutered yet? (Must be done by 6 months) *
If yes, may we use a haltie (a training device, also called a gentle leader) to distract them? *
CENTRAL BARK DOGGY DAYCARE, LLC SERVICE AGREEMENT AND WAIVER OF CLAIMS: *
Parties: Central Bark Doggy Daycare, LLC (Company) and Customer, as listed in the registration form above (Customer). Agreement: The Parties agree as follows: Customer understands that Company will be providing the following services: Dog daycare, overnight boarding, dog grooming, dog walking, dog shuttle, in-home pet care. While Company will provide such services in a responsible, careful manner, Customer acknowledges that Company and its employees cannot be, and are not, liable in the unlikely event of injuries or damages. Waiver of Liability: Customer hereby releases Company and its employees from any liability, whether arising from breach of contract, negligence, or otherwise, alleging injuries or damages of any kind, including but not limited to personal injury, pet injury, bodily injury, property damage, or property loss. Limitation of Time for Commencement of Claims: Customer agrees that any claim against Company or its employees, including but not limited to claims of negligence or breach of contract, alleging injuries or damages of any kind, including but not limited to personal injury, pet injury, bodily injury, property damage, or property loss, shall be barred unless asserted by the commencement of an action in a court of law within one year after any such cause of action arises. Limitation of Damages: Customer agrees that, in any event, the amount of damages or liability that Customer may recover from Company or its employees, whether arising from breach of contract, negligence, or otherwise, alleging injuries or damages of any kind, including but not limited to personal injury, pet injury, bodily injury, property damage, or property loss, is limited to the amount of $1,000. Acceptance: Click the “ACCEPT” box below if you agree to be bound by the terms of this Agreement. Click the “DECLINE” box if you do not agree to the terms of this Agreement. If you click the “ACCEPT” box, the Agreement will be effective as of the date of acceptance.
Date *
Date

PLEASE NOTE: If you don't see the confirmation page after hitting submit, you have errors (in red) to correct. Thank you!