Boarding Agreement

Casa Querencia Boarding Agreement
Mailing Address: 1607 Fowler Rd. Roswell, NM 88201
Phone: 575-625-9772 Fax: 866-521-7566
Owner’s Name: ________________________________________________________________________
Address: _____________________________________________________________________________
City: ______________________________ State: _________________Zip:_________________________
Preferred method to be contacted: Phone: _________________________________ Work Phone: ____________________________
Cell Phone: ______________________________ Email: _______________________________________
Name of Animal: ___________________________________ Breed: _____________________________
Color: __________________________________________ Age: _________________________________
Best method of contact: ________________________________________________________________
Contact preference (call, text, etc.)________________________________________________________
Please circle one of the following: Neutered Male Spayed Female Unaltered Female Unaltered Male
If your dog was adopted from a shelter or previous living arrangement do you know its history? Yes No Does your dog jump fences? Yes No
How long have you owned this dog? __________________________
Please describe how your dog gets along with other dogs____________________________________________________________________
What flea prevention is your dog wearing and when was it last applied?
Date applied: _____________________
 K9 Advantix Advantage  Frontline  Nexgard  Sentinel Other:__________________
Is there any food or treat your dog is NOT allowed to have? _______________________
What does your dog REALLY like? (Please list as much as possible):
Kong’s Belly Rubs  Fetch  Other: __________________
What does your dog NOT like?  Strangers Nails being clipped  Being Alone Loud Noises Thunder Storms  Vacuums  Water
Do you often go to local dog parks? Yes (if yes where?)____________________  No What is the primary reason you are enrolling your dog in our boarding kennels?
 Socialization  Exercise  Boarding  Other: ____________________________
What kind of dog does your dog tend to get along with best? (Breed, size, temperament, gender):_________________________________________________________________
Is there any kind of dog you dog does NOT get along with? (Breed, size, temperament, gender):_________________________________________________________________
How does your dog interact with people including strangers? _______________________________________________________________
Does your dog have any pre-existing medical conditions or allergies? No Yes (if yes please further describe them):_____________________________________________
Can your dog lie on a blanket or towel without ingesting it? Yes No
• Dogs still intact after 8 months of age may not receive as much turn out time due to reproductive abilities
Dogs are turned out in the yard with other dogs. If you do not wish this to happen please specify below:
 Yes, my dog can be turned out with other dogs during play time.
 No, I do not want my dog turned out I prefer him/her hand walked. (Please note: This preference is an additional cost for hand walking. $5.00 for every 15 minutes of hand walking.)
Does your dog cough, sneeze, wheeze, or exhibit any asthmatic Symptoms? YES or NO
Has your dog been boarded before? YES or NO
Has your dog ever bitten another animal or a person? YES or NO
Has your dog ever been attacked by another dog, or abused? YES or NO
If yes, please further explain: _______________________________________________________
Medical Emergency Information:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Veterinarian’s Name/ Clinic: _______________________________________________________
Phone: __________________________ Address: ______________________________________
City: ____________________________ State: ___________________ Zip: __________________
Do you have a payment method prearranged with your veterinarian in case of an emergency? Yes or No
Vaccinations (Please note: we require proof of all vaccinations)
Verified Vaccines 
Please list the most recent date of the following vaccinations:
Rabies: ________________________ Distemper/Parvo: _______________________________
Bordetella: ___________________________ Other: __________________________________
*Please adhere a copy of medical records from veterinarian. Please note vaccinations administered by owner are not acceptable.
Please describe any medical or physical problems (include seizures, separation anxiety, etc…)
__________________________________________________________________________________
__________________________________________________________________________ Emergency Contact (if other than the Owner):________________________________________________________________________
Owner Signature: ______________________________________________________
Date: ________________________________
***PLEASE READ***
Policies: • Casa Querencia cannot guarantee that toys, blankets, or bedding will be kept in the same
condition as initially brought in. For safety purposes Rawhide is NOT allowed.
• All animals boarding must be current on all vaccines.
• Dog Owner understands the risks involved with communal boarding of dogs. Our boarding and Daycare facility’s allow dogs to play in the yard with other dogs. Although we will offer reasonable care, the unpredictable personality of dogs can sometimes lead to injury.
• Dog Owner understands that Casa Querencia’s liability of any circumstance related to the dog will not exceed the current chattel value of a dog of the same breed as the one in our care.
• UNACCEPTABLE ANIMALS: Casa Querencia reserves in our sole discretion the right to refuse to accept, or reject upon acceptance, any dog who we believe would not safely integrate with the rest of the animals, or who we believe does not have an appropriate temperament to integrate into our environment. This includes, but is not limited to, aggressive, anti-social, overly active, overly anxious or physically ill dogs.
By submitting this form,
a) You indicate you agreement with all the terms hereof.
b) You acknowledge the risks of communal boarding. Dogs playing together in playgroups can sometimes result in injuries or spreading of such illnesses as Kennel Cough.
c) You release, indemnity and hold Casa Querencia harmless from any and all manner damages, claims, losses, liabilities, costs or expenses, causes of action or suits, whatsoever in law or equity (including, without limitation, attorney’s fees and related costs) arising out of or related to the services provided by Casa Querencia, except which may arise from sole gross negligence or intentional and willful misconduct of Casa Querencia, including, without limitation: (i) any inaccuracy in any statement made by yourself or information provided by you to Casa Querencia (ii) your dog, including but not limited to destruction of property, dog bites and transmission of disease, and (iii) any action by yourself which is in breach of the terms and conditions of this Agreement. d) This Agreement covers the current relationship between Casa Querencia and yourself. Each time you bring your dog to Casa Querencia, you affirm the terms of the Agreement and the truthfulness and accuracy of all statements you make in this Agreement.
Please remember to call the location directly for boarding reservations. To ensure your dog’s safety, as well as that of our existing Boarding kennel, you are required to bring a copy of your dog’s updated shot records from your vet before you are allowed to start with us. Signature:________________________________________ Date:________________
Owner
Signature: _________________________________________ Date: _______________
Casa Querencia Representative

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