Emergency Contact (Other than yourself)*

Owner's Name*

Photo Release Form

I, the undersigned, was informed that pictures of my dog(s) shall be used on Jorgensen’s Doggy Barn’s website and in print (e.g. flyers) for advertising the facility and its services. I give permission to Jorgensen’s Doggy Barn to photograph my dog(s) and to use the photo(s) on their website, social media accounts and in print for advertising the facility and its services

Health and Temperament Agreement

I understand I am solely responsible for any physical harm caused by my dog(s) while staying at Jorgensen’s Doggy Barn. I agree to pay for damages and/ or medical bills incurred as a result of my dog(s) actions. I further understand that Jorgensen’s Doggy Barn and its employees/ volunteers have relied on my representation of my dog(s) health as well as any and all aggressive or threatening behavior displayed by my dog(s) toward any person and/ or other dog. Furthermore, I understand that Jorgensen’s Doggy Barn and their staff will not be liable for any problems that may occur involving my dog(s) provided reasonable care and precautions are followed, and I hereby release them from any and all liability that may arise as a result of my dog(s) attendance at Jorgensen’s Doggy Barn. In addition, I understand that any problem(s), medical or otherwise, that may arise involving my dog(s) will be handled as deemed necessary by Jorgensen’s Doggy Barn and their staff, and that I am financially responsible for any and all the costs involved. My signature below certifies that I have read and understand all the information on the preceding pages and have answered all my questions truthfully and to the best of my ability and agree to abide by all the terms and conditions set forth with in this agreement.

Your Signature*