Dog Sitting Questionnaire & Release

Owners Name:____________________________________________
Address, City, State, Zip____________________________________
Home Phone/Cell Phone____________________________________
Email _____________________________________________

Vet Name & Phone__________________________________
Emergency contacts(name/phone)___________________________________

I, the undersigned, hereby release Mary Ann Moore/The Greyhound Hotel
 from any & all liability that may occur during the stay of my dog(s).
I also will hold harmless the aforementioned for any injury that may occur.
This may include any claim(s) that I or family member may have for loss,damage,or injuries arising from the sitting of this/these hound(s).
I understand that Mary Ann Moore will make reasonable attempt to insure the welfare & health of my hound(s). 
In an emergency, appropriate medical care will be obtained. I understand 
and agree that I may be responsible for said medical bills if such a situation should arise.
Please initial: ____________

Dog(s) Name Age(s) M or F __________________________________
                                    _______________________________________       
Any physical problems:    _____________________________________
Any current medications?   ___________________________________
Brand of food/amount usually fed ______________________________
Aggressive near food? :  _________________

How often are they used to going outside:___________________________
Does the dog(s) give signs to go out?_____________________
Do you crate or gate off when you leave?________ At night?__________
Allowed on furniture?_________________________________ 
Does your dog(s) do stairs_________________________________
Fearful of storms?_________________________________________

Any additional information or comments regarding your dog(s):_______________________________________________________
_____________________________________________________________

THANK YOU FOR FILLING OUT THIS FORM, IT WILL HELP 
ASSURE THE COMFORT AND SAFETY OF YOUR HOUNDS 
DURING THEIR STAY AT THE GREYHOUND HOTEL SO YOU 
               CAN RELAX AND HAVE A NICE TRIP!!!