TAILWAGGERS Boarding and Daycare Agreement

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133 N Ohio Ave ● Wichita, KS 67214
(316) 221-1163
www.TailwaggersWichita.com

Owner Name(s) : *

Address : *

City *

State *

Zip *

Cell Phone *

Home Phone

Work phone

Email *

How did you hear about TAILWAGGERS?

Authorized alternate contact for dog(s). NAME

Authorized alternate contact for dog(s). PHONE

Authorized alternate contact for dog(s). RELATIONSHIP

The above-named person is authorized by me to:

Pick-up my dog(s) from boarding or daycare?

Make decisions for my dog(s) on my behalf in an emergency?

Make decisions for my dog(s) on my behalf in non-emergency situations?

By checking here, you may verbally (by telephone) or in writing (facsimile or otherwise) request that TAILWAGGERS release your dog to someone other than the person(s) listed above, and you release TAILWAGGERS of and from any and all responsibility for releasing your dog to any person TAILWAGGERS reasonably believes to be authorized by yourself. *

CHECK HERE

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