Reg i s t ra t io n App l ic a t io n and Agreemen tHug-A-Bubba ’s and the Pe t Owner (s ) named be low agree as fo l lows :

Pe t ’ s name Breed AgeM F Spayed/Neu tered? Y N Co lor

We igh t F lea t rea tmen t? Wh ich brand?

Pe t Owner ’s Name(s )Address C i ty Sta te Z i p Code

Pr imary Phone Mob i l e# Work#E-Ma i l How d id you hear abou t us?

Emergency Con tac t Name Phone #

Who e lse i s au thor i zed to p ick up your pe t? Phone #Ve ter i nar i a n Name : Phone #P lease no te any med ica l cond i t io ns/ In ju r ies/Al le rg ies your dog has

Is your pe t tak i ng any med ica t io ns? Y N I f yes , p lease descr i be

Ge t t i ng to know your dog (mark a l l tha t app ly )Ca lm/La id back

H igh EnergyDom inan tAnx iousMa tureShy

Hyperac t i vePro tec t i veImma tureFood Aggress i veFearfu lAggress i ve

Toy Possess i veP lay fu lEscape Art i s tEa ts FecesDes truc t i veIndependen t

MarksL i kes to Moun tPees when exc i tedBark when p lay i ngEa ts Rocks/D i r tAfra id o f Strangers

Jumps on Peop leSepara t io n Anx ie tyAfra id o f No i ses

Does your dog jump fences? Y N I f yes , how h igh?How does your dog reac t when mee t i ng new dogs?Wha t behav ior does your dog d i sp lay when w i th o ther dogs i n a group se t t i ngs? (dog parks/p laygroups? )Does your dog have a s t rong prey dr i ve? Y NHas your dog ever harmed a sma l l a n ima l? ( rabb i t , squ i rre l , e tc ) Y NI f yes , p lease descr i beHas your dog ever harmed or been aggress i ve towards ano ther dog? I f yes , p lease descr i be

Y N

Has your dog ever b i t te n or shown aggress ion towards peop le? I f yes , p lease descr i be

Y N

Obed ienceIs your dog cra te t ra i ned? Y N Has your dog a t tended obed ience c la sses? Y NCommands my pe t knows :

S ITDOWN

STAYWAIT

COMEHEEL

LEAVE ITOFF

EASYGENTLE

Terms and Cond i t io nsHea l th/Vacc i na t io ns

Re fusa l o f Serv ices : Hug-A-Bubba ’s may, a t i ts so le d i scre t io n , re fuse to prov ide serv ices to or adm i t my dog i n to i ts daycare . I f Hug-A-Bubba ’s i n i t i a l l y adm i ts my dog i n to daycare bu t subsequen t ly de term i nes tha t i n i ts op i n io n my dog ’s behav ior i s no t su i tab le to be i n daycare , then Hug-A-Bubba ’s may therea f ter re fuse my dog ’s adm i t ta nce . I f Hug-A-Bubba ’s i n i ta l l y adm i ts my dog, bu t subsequen t ly de term i nes tha t i n i ts op i n io n my dog has an i l l ness , then Hug-A-Bubba ’s may a t i ts op t io n e i ther segregra te my dog i n Hug-A-Bubba ’s quaran t i ne room or requ i re tha t I immed i a te ly re tr ieve my dog .

R igh t to Pho tograph : I agree tha t my dog may be v ideo taped and/or pho tographed by Hug-A-Bubba ’s . Hug-A-Bubba ’s sha l l be the exc lus i ve owner o f the resu l ts and proceeds o f such tap i ng or pho tography and may use such tap i ng and pho tos for any o f i ts advert i s i ng or marke t i ng . I fu r ther agree tha t my dog may be used i n any and a l l med i a and the promo t ion , advert i s i ng , sa le , or pub l ic i z i ng o f Hug-A-Bubba ’s .

Warran t ie s and Represen ta t io ns : I warran t and represen t tha t : (a ) my dog i s no t now and has never been known to be aggress i ve towards or a t tack ano ther an ima l or human; (b ) tha t a l l o f the i n forma t ion prov ided by me i n th i s agreemen t i s t rue and correc t to the bes t o f my know ledge and be l ie f ; (c ) tha t I am the owner o f the dog descr i bed i n th i s agreemen t ; and (d ) I am au thor i zed to en ter i n to th i s agreemen t .

Au thor i ty for Emergency Care : I n the even t tha t Hug-A-Bubba ’s de term i nes i n i ts so le d i scre t io n tha t my dog requ i res med ica l a id , I au thor i ze Hug-A-Bubba ’s i n i ts so le d i scre t io n to adm i n i s ter and/or obta i n care by a l icensed ve ter i nar i a n o f Hug-A-Bubba ’s cho ice i nc lud i ng tes t resu l ts , med ica l records and/or prescr i p t io ns . I agree to pay any such cos ts i ncurred by Hug-A-Bubba ’s and/or re imburse Hug-A-Bubba ’s for any such expenses pa id by Hug-A-Bubba ’s . I au thor i ze and i n s t ruc t any ve ter i nar i a n s ta ted above to re lease Hug-A-Bubba ’s any and a l l i n forma t ion regard i ng my dog .

Ho ld Harm less and Re lease o f L i ab i l i ty : On beha l f o f a l l Owners o f my dog, I acknow ledge and agree (a ) tha t Hug-A-Bubba ’s sha l l no t be l i a b le for any i n ju r ies , i l l nesses or acc iden ts i nvo lv i ng my dog, i nc lud i ng escape or loss o f my dog,wh i l e my dog i s i n the care or cus tody o f Hug-A-Bubba ’s , and (b ) to de fend , ho ld harm less and i ndemn i fy Hug-A-Bubba ’s from and aga i ns t any and a l l cos ts , expenses , a t torney ’s fees , or damages ar i s i ng ou t o f any c la im, ac t io n , su i t or proceed i ng concern i ng my dog and/or o ther dogs or an ima ls i n the care or cus tody o f Hug-A-Bubba ’s and/or any na tura l person where such c la im, ac t io n , su i t , or proceed i ng i s caused by or re la tes to my dog wh i l e i n Hug-A-Bubba ’s care .

Lega l fees : I n the even t a d i spu te ar i ses w i th respec t to th i s agreemen t , the preva i l i ng par ty sha l l be awarded a l l reasonab le lega l fees and re la ted cos ts i ncurred i n connec t io n w i th the d i spu te .

M i sce l l a neous : The terms o f th i s Agreemen t sha l l no t be mod i f ied excep t i n wr i t i ng s igned by Hug-A-Bubba ’s and the Owner . Th i s Agreemen t sha l l be governed by the laws o f the Sta te o f Oregon . Venue for any ac t io n sha l l be Wash i ng ton Coun ty , Oregon . The words “owner , ” “my, ” “ I ” a nd o ther s im i l a r words re fer co l l ec t i ve ly to a l l owners o f the above named dog . I cer t i fy tha t a l l owners , have read and fu l l y unders tand the terms o f th i s agreemen t and have g i ven me the au thor i ty to en ter i n to and execu te th i s agreemen t . Th i s agreemen t has no t ime l im i t a nd i s va l id and en forceab le for any and a l l o f my dog ’s fu tu re s tays w i th Hug-A-Bubba ’s . De l i very to Hug-A-Bubba ’s o f th i s Agreemen t s igned by Owner may be made by hand , ma i l , facs im i l e or ema i l .

I agree tha t I w i l l no t br i ng my dog to Hug-A-Bubba ’s i f I am aware o f i t exh i b i t i ng any s igns o f sneez i ng , vom i t i ng , d i a rrhea , cough i ng , le thargy or any o ther i nd ic a t io n o f i l l ness and o therw i se cer t i fy tha t , to the bes t o f my know ledge , my dog i s i n good hea l th . I agree to prov ide proo f tha t a l l o f my dog ’s requ i red vacc i na t io ns are curren t pr io r to my dog ’s f i rs t a rr i va l day and ev idence tha t they rema i n curren t for a l l subsequen t arr i va ls . Requ i red vacc i na t io ns are as fo l lows :

RABIES - 1 to 3 year vacc i na t io n depend i ng on Ve t ’ s recommenda t io nBORDETELLA - 6 mon ths or 1 year (6 mon ths recommended)DHLP-PV - 1 to 3 year vacc i na t io ns depend i ng on Ve t ’ s recommenda t io n

End o f Day P ickup : I agree tha t e i ther I or my au thor i zed agen t w i l l p ic k up my dog no la ter than Hug-A-Bubba ’s c los i ng t ime . Hug-A-Bubba ’s c los i ng t ime i s 6 :30 pm Monday - Fr iday and 2 :00 pm on Sa turdays . I f my dog i s p icked up la ter than 6 :35 pm, I agree to pay Hug-A-Bubba ’s l a te charge fee o f $ 1 .00 per m i nu te . I f Hug-A-Bubba ’s does no t hear from you by phone by 6 :45 pm, I u nders tand and agree tha t : (a ) I w i l l therea f ter be unab le to p ick up my dog tha t day ; (b ) Hug-A-Bubba ’s w i l l house my dog overn igh t i n an overn igh t board i ng area ; (c ) my dog can be p icked up when Hug-A-Bubba ’s opens a t 6 :30 am the fo l low i ng bus i ness day . (d ) I w i l l pay Hug-A-Bubba ’s norma l overn igh t board i ng charges o f $40/n igh ti n add i t io n to the norma l dogg ie daycare charge ; Any dog no t p icked up f i f teen days or more a f te r i ts schedu led departure da te w i l l be cons idered abandoned and a t Hug-A-Bubba ’s d i scre t io n may be tu rned over to the proper au thor i t ie s .

PET OWNER

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HUG-A-BUBBA’s

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