CLIENT & HOME INFORMATION: Dog Owner’s Name: ______________________________
Name of Dog(s)* Cats/pet : ____________________________________________ ___________________________________________________________________ ___________________________________________________________________
Address: _____________________________________ City___________________________________ Zip_______
Phone: _______________________________
Email Address: ____________________________________________
Spouse's name: _____________________________________
Spouse phone: ______________________________
Spouse's e-mail Address: ____________________________________________
Emergency Contact and Phone Number: _____________________________________________________________
Secondary Emergency Contact and Phone Number: ____________________________________________________
*For more than one dog you may print and submit the additional Dog Information sheets as necessary. (see page 3) Dog Walking times- please give us at least a 1 hour time window
N/A N/A SECURITY SYSTEM (If home has system):
Company Name: ______________________________ Security Co. Phone Number: ______________________________ Password: ______________ Code: ______________ Door Entering (must be near keypad): ________________________ Arming Instructions: ___________________________________________________________________________________ Disarming Instructions: _________________________________________________________________________________ PROPERTY DESCRIPTION: Security Fence: □ Yes □ No Gates Properly Working: □ Yes □ No Invisible Fence: □ Yes □ No Pet Door: □ Yes □ No Describe any problems with the fence (i.e. gate not easily latched, holes under fence, etc): _________________________________________________________________________________________________
How will walker enter home or yard? ___________________________________________________________________
Location of cleaning supplies (waste bags, solvents, broom, dustpan, paper towels, etc.): _________________________________________________________________________________________________
Parking Instructions (if needed): ______________________________________________________________________
Location of leash, poop bags, treats_____________________________________________________________________
Where should we dump poop bags after walk? ______________________________________________________
Keys: Please have 1 key ready for us when we meet - be sure you have checked it in your locks
You must cancel walks with a minimum 24 hours notice for a credit. You will be charged full price for walks cancelled with less than 24 hours notice. Initial: __________
The parties to this Dog Walking Agreement (hereinafter referred to as the “Contract”) and Port Jervis Pet Sitting /Dog Walking (hereinafter referred to as "the Walker") and ___________________________________________________________ (hereinafter referred to as "the Owner"). A Dog Information Sheet and a Veterinarian Release Form must be completed and signed prior to service (for each pet) so that we may provide the best care possible. Whereas the Owner wishes to engage the Walker and the Walker agrees to undertake the services under the terms and provisions defined in this Contract, as well as the forms mentioned, all of which shall become part of this Contract. Any reference to dogs or pets in this Contract shall refer to those specified on the Dog Information Sheet(s). 1.) Relationship and Responsibilities: It is expressly understood that the Owner retains the services of the Walker as an independent Contractor and not as an employee. The Walker shall be responsible for his/her insurance and all statutory declarations and payments with regard to income tax where applicable. The Walker undertakes to perform the agreed-upon services in an attentive, reliable and caring manner, and the Owner undertakes to provide all necessary information to assist in this performance. The Walker undertakes to notify the Owner of any occurrence pertaining to the dog which may be relevant to the care and well-being of the dog. The Walker will be supplied and be equipped with waste bags and will duly remove the dog's feces from all public places. The Owner will provide suitable harnesses, collars and non-retractable leashes as approved by the Walker, as well as muzzles if required. The Walker reserves the right to adjust walking times due to extremely hot or stormy weather. If the Owner desires the dog’s feet to be wiped off during wet weather, Owner shall provide a towel to be left at the point of entry used by the Walker. Initial: __________ 2.) Compensation: The Walker shall be paid the amount of $_________ per walk. Owner will pay monthly or weekly in advance of walks. Visits are for approximately 30 minutes and include: 20-25 minute walk, fresh water refill, attention and treats afterwards. Additional time can be added for a nominal fee. A $35 fee will be charged for all returned checks plus any bank fees incurred. 3.) Duration: This Contract shall become effective on ____________________________. Either party may terminate this Contract with a minimum of 24 (twenty four) hours notice prior to the scheduled visit without incurring penalties or damages. Cancellation by the Owner of scheduled walks with less than 24 hrs notice will be charged at the full rate. If a specific employee of the Walker cannot perform the service at a scheduled date or time, then the Walker may assign a substitute employee. Should any dog become aggressive or dangerous, the Walker may terminate this Contract with immediate effect. Any wrongful or misleading information in the Owner's Information or Pet Information sheets may constitute a breach of terms of this Contract and be grounds for instant termination thereof. Termination under the circumstances described above shall not entitle the Owner to any refunds or relief of any outstanding payments due. 4.) Liability: The Walker will carry liability insurance relative to the services performed for the Owner. A copy of the insurance policy has been made available to the Owner and the Owner acknowledges that he/she is familiar with its content.
The Walker accepts no liability for any breach of security or loss of or damage to the Owner's property if another person has access to the property during the term of this Contract. The Walker shall not be liable for any mishap of whatsoever nature which may befall a dog or be caused by a dog who has unsupervised access to the outdoors. The Owner shall be liable for all medical expenses and damages resulting from an injury to the Walker caused by the dog, as well as damage to the Owner's or other persons’ pets or property. The Walker is released from all liability related to transporting dog(s) to and from any veterinary clinic or kennel, the medical treatment of the dog(s) and the expense thereof. 5.) Indemnification: The parties agree to indemnify and hold harmless each other as well as respective employees, successors and assigns from any and all claims arising from either party's willful or negligent conduct. 6.) Emergencies: In the event of an emergency, the Walker shall contact the Owner at the numbers provided to confirm the Owner's choice of action. If the Owner cannot be reached, the Walker is authorized to either: (1) transport the dog(s) to the listed veterinarian, (2) request on-site treatment from a veterinarian, or (3) transport the dog(s) to an emergency clinic if the previous two options are not feasible. Owner agrees to reimburse the Walker for all expenses incurred up to a limit of $______________. We suggest that you leave a credit card on file with your veterinarian with a specific charge limit. This could save your pet’s life in a case when we are unable to reach you.
Initial: __________ 7.) Security: The Walker warrants to keep safe and confidential all keys, remote control entry devices, access codes and personal information of the Owner and to return same to the Owner at the end of the Contract period or immediately upon demand. . By signing below the Owner fully understands and agrees to the contents of the above agreement:
******YOU MUST SIGN THIS AGREEMENT TO BEGIN PET CARE. Dog Owner's Signature: _____________________________________________________ Date: ______________
Port Pet Sitting/Dog Walking Signature: _________________________________________________ Date: _______________ Payment for Services will be with: □ Cash □ Check Will you pay monthly or weekly (please circle one
INFORMATION SHEET: Please fill out one form for each dog so that we may provide the best care possible. In case of any emergency, a signed Veterinarian Release Form is also necessary for our files. Thank you. Important: No Retractable Leashes! Please provide a standard leash for your dog. Dog’s name: ___________________________________ DOB: ___________________________
□ Male □ Female □ Spayed □ Neutered
Your dog’s approx weight: _______________________________
Breed: ______________________________
Markings: __________________________________________________
Vaccines Up to Date? □ Yes □ No □ DHLPP (or similar) □ Bordetella (kennel cough) □ Rabies Micro-chipped? □ Yes □ No Chip#: ______________ Registry Company: ______________________________ Is your dog licensed with the city? □ Yes □ No License#: ______________________________________________ Does your dog need any Medications? □ Yes □ No (If ‘Yes’, a Medication Authorization Form must be completed and on file) What form of flea & tick control do you use? ______________________ Last date it was administered __________ When you walk your dog, if he sees another dog, does he: □ Ignore the other dog □ Show some interest but keep walking □ Wag his tail in a playful manner and wants to play □ Growl and become aggressive □ Pull hard on the leash in an attempt to get to the other dog When you walk your dog, if he sees a cat or other small animal does he: □ Ignore the animal □ Show some interest but keep walking □ Wag his tail in a playful manner and wants to play □ Growl and become aggressive □ Pull hard on the leash in an attempt to get it What commands does your dog understand: □ sit □ stay □ down □ off □ ______________ □ ______________ Other: ___________________________________________________________________________________________
Does your dog come when called? □ Yes □ No
What is your dog’s “come” command? __________________________
Does your dog walk calmly or pull when walking: _____________________________________________________
Is there anything in particular we should be aware of when caring for your dog? (Scared of loud cars, skateboards, kids? Eats objects/garbage on walks, health issues, allergies, etc? ) ________________________________________________________________________________________________________ ______________________________________________________________________________________________________
OK to give treats? □ Yes □ No
Additional Notes: (another sheet may be attached for further details) __________________________________________________________________________________________________________ __
Port Pet Sitting and Dog Walking Services
Diane Donahue
Find us on FaceBook @portpetsitter
And Instagram: port_jervis_petsitting
845-741-9519
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