WELCOME TO “CAMP OPAH” at Orchard Park Animal Hospital

Complete the form below to register for the Canine Campers at Camp OPAH.

CANINE CAMPERS

Owner's Name(Required)

Pet's Name(Required)

Phone Number(Required)

Email(Required)

Emergency Contact Name(Required)

Emergency Contact Phone Number(Required)

Does your pet use heartworm/flea/tick medication(s)?(Required)

Yes

Product name(s)(Required)

Date(s) of last dose(s)(Required)

Arrival Date/Time(Required)

MM slash DD slash YYYY

(Before 4pm only)*

Departure Date/Time(Required)

MM slash DD slash YYYY

(between 9am-5pm)*

Requirements for Campers: All canine campers are required to be up-to-date on vaccines (Rabies, DAP, Bordetella) and parasite prevention (heartworm, intestinal parasite, flea, tick). It is recommended that vaccines be administered at least 2 weeks prior to boarding to increase efficacy. No vaccine is 100% but especially Bordetella (Kennel Cough) may not be as
effective if administered at the same time as boarding. ALL VACCINES MUST BE ADMINISTERED BY A CERTIFIED VETERINARIAN.

Parasite-Free Facility: All campers will be examined by a camp counselor upon admission. If external parasites (fleas, ticks,
etc) are found the pet will be treated appropriately at the owner’s expense. All campers not up-to-date on intestinal parasite prevention will be screened and If parasites are found the pet will be treated appropriately, all at owner’s expense.

Please select a diet option(Required)

I would like Camp OPAH to feed my pet the special campers diet (i.e. Purina EN or Hill’s Science Diet)

I would like my pet fed its regular diet (must be provided at time of arrival)

How Much (Cups)(Required)

How Often (Times/Day)(Required)

May Camp OPAH use pictures taken of your pet during the stay on our website/other social media.(Required)

Yes

Upgrades

Please Check Which Upgrades You’d Like to Provide Your Camper

Medication(s): $14/day – Please list below

Puppy Campers (less than 6 months of age)**: $17.50/day – includes a midday lunch, two extra walks outside, and time with a camp counselor working on tricks.

Camp Lounge Time**: $17.50/day – receive 20 minutes of private time to lay around on the couch, watch tv, play with different toys around the lounge and cuddle time with one of the camp counselors. Take a peek through our doggie cam if you’d like to see your pet! Not available Saturdays or Sundays

Camper Treat: $8/day – receive a KongⓇ filled with a different treat daily.

Camper Anxiety: $15/day – receive ProviableⓇ FORTE and ZylkeneⓇ to help soothe your camper’s tummy and calm your camper’s stress.

Camper Daily Update**: $8/day – receive updates with a picture via text and/or email of your camper and their daily activities.

Departure Day Spa Treatment: $50.21 and goes up depending on weight – includes bath, nail trim, and ear cleaning on the day your pet is to be picked up. Departures after 2pm please. (50% discount with stays of 7 days or longer)

* Departures outside of 9am-5pm may be subject to an additional $20 fee.

Please list medication(s) and dosage(s).(Required)

* Medication(s): $10/day

Please list phone and email if different than above

* Camper Daily Update

Check Boxes For Camp Lounge Time Days(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

*Camp Lounge Time

Please Select the Days You Would Like to Get Camper Updates On.(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

* Camper Daily Update

These Boarding Agreement Terms and Conditions are by and between the Owner listed on the first page of the Agreement (“Owner”) and Orchard Park Animal Hospital (“Camp OPAH”). The first page of this Agreement is hereby included by reference. These terms and conditions are applicable to the Owner and any pet(s) listed on the first page of the Agreement and shall remain in full force and effect for all of the Owner’s pets that receive services hereinafter whether individually listed or not (“Pets”).

Payment for services is due at the time of pickup. Owner agrees to pay the rate for boarding in effect on the date pet is checked in for boarding. Owner agrees to pay all costs and charges for special services requested. Furthermore, if the Pet becomes ill or if the state of the Pet’s health otherwise requires attention, Camp OPAH at its sole discretion, is authorized to engage the services of our veterinarian(s) and/or arrange for other requisite attention to the Pets.

Non Emergency Conditions(Required)

Please treat non-emergency conditions up to $100 without contacting me.

Please do NOT treat non-emergency conditions without contacting me.

In the event of an emergency, Camp OPAH will make reasonable effort to contact owner and/or emergency contact using the information provided on Page 1. Regardless if veterinarian determines that emergency treatment is needed it will be performed. 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.

Camp OPAH shall exercise reasonable care for Pet. However, due to the social nature of a kennel, there are some inherent risks in boarding Pets. These risks may include, but are not limited to, communicable diseases such as Kennel Cough
(Bordetella), stress-related diarrhea and minor injuries including, but not limited to, broken nails, sore feet, puncture wounds, abrasions and cuts. These injuries are generally benign and can usually be managed by our staff or at home. In some cases, veterinary care may be required. Camp OPAH shall exercise reasonable care for any toys, bedding, and/or other property left with pet. However Camp OPAH is not responsible for damage, destruction, and/or loss of such property.

It is expressly agreed by Owner and Camp OPAH that Camp OPAH’s liability, if any, shall not exceed fair market value for the Pets boarded or the total daily boarding fees of the visit, whichever is less. Owner agrees to release, indemnify, and hold harmless Camp OPAH from any and all manner of damages, claims, loss, liabilities, costs or expenses, including reasonable attorney’s fees and related costs, arising out of or related to Camp OPAH’s services, including, without limitation, (i) any inaccuracy in any statement made by yourself or information provided by you to Camp OPAH (ii) your Pet, including but not limited to destruction of property, dog bites, injuries, and transmission of disease, and (iii) any action by Owner which is in
breach of the terms and conditions of this agreement. The Owner further agrees to be solely responsible for any and all acts or behavior of Pets while it is in the care of Camp OPAH.

Owner agrees that in the event the boarding charges are not paid when due in accordance with this agreement, Camp OPAH may charge interest at the rate of 1.5% per month until paid in full. In the event legal action is taken to enforce the terms of this agreement Owner agrees to pay Kennel’s court costs and reasonable attorney’s fees. A Pet that is unclaimed at Camp OPAH for ten (10) days beyond its scheduled discharge date is considered abandoned and will become the property of Camp
OPAH.

This Agreement contains the entire agreement between the parties. This Agreement shall be governed by and construed in accordance with the laws of the State of Tennessee and each party consents to the exclusive jurisdiction of the said state. Furthermore, the parties agree that any legal actions shall be subject to the venue of the court of competent jurisdiction in Robertson County.

In consideration for services to be provided, I agree that I have read and fully understand the terms, conditions, and statements on Page 2 of this agreement, receipt of which is hereby acknowledged, and that I agree to said Terms and Conditions. I also certify that the information given above is accurate to the best of my knowledge, I am 18 years of age or older and the lawful and valid owner of the Pet, free and clear of all liens and encumbrances.

Signature

Date

MM slash DD slash YYYY

Name

This field is for validation purposes and should be left unchanged.