Lake Orion, MI (248) 391-4200

New Customer Reservation Request

This form is for new customers only.

If you are an existing customer, kindly please fill out our Reservation Request form.

Submitting this form does not guarantee a reservation.
You will receive a confirmation email or phone call.
Thank you.
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Owner's Information

Full Name:(*)

Home Phone #:
Work Phone #:
Street Address:

City:

State: ZIP:
Cell Phone #:
Email Address:(*)

Emergency Contact(s)

Emergency Contact #1 Name:

Emergency Contact #1's Phone:

Emergency Contact #2 Name:

Emergency Contact #2's Phone:

Veterinarian's Name:

Veterinarian's Phone:

Dates Requested

Start Date

(mm/dd/yyyy)

End Date

(mm/dd/yyyy)

Pet Information

Please fill out pet information for each pet to be boarded.

Pet #1 Information

Dog or cat?

Name:

Breed:
Color:

Birthdate:
Weight:
Gender:
Spay or Neuter:
Brand of Food:

Quantity of Food:

Feeding Time(s):



Pet #1 Medical History

Is pet on Heartworm preventative?

 Yes No

How often is the Heartworm preventative administered?

 Daily Monthly

Is your pet on any other medications?

 Yes No

Please list each medication that your pet needs and how often it needs to be administered:

Medical History (skin, teeth, ear problems, etc.)

Pet #2 Information

Dog or cat?

Name:

Breed:
Color:

Birthdate:
Weight:
Gender:
Spay or Neuter:
Brand of Food:

Quantity of Food:

Feeding Time(s):



Pet #2 Medical History

Is pet on Heartworm preventative?

 Yes No

How often is the Heartworm preventative administered?

 Daily Monthly

Is your pet on any other medications?

 Yes No

Please list each medication that your pet needs and how often it needs to be administered:

Medical History (skin, teeth, ear problems, etc.)

Pet #3 Information

Dog or cat?

Name:

Breed:
Color:

Birthdate:
Weight:
Gender:
Spay or Neuter:
Brand of Food:

Quantity of Food:

Feeding Time(s):



Pet #3 Medical History

Is pet on Heartworm preventative?

 Yes No

How often is the Heartworm preventative administered?

 Daily Monthly

Is your pet on any other medications?

 Yes No

Please list each medication that your pet needs and how often it needs to be administered:

Medical History (skin, teeth, ear problems, etc.)

Pet #4 Information

Dog or cat?

Name:

Breed:
Color:

Birthdate:
Weight:
Gender:
Spay or Neuter:
Brand of Food:

Quantity of Food:

Feeding Time(s):



Pet #4 Medical History

Is pet on Heartworm preventative?

 Yes No

How often is the Heartworm preventative administered?

 Daily Monthly

Is your pet on any other medications?

 Yes No

Please list each medication that your pet needs and how often it needs to be administered:

Medical History (skin, teeth, ear problems, etc.)

ORION KENNEL CLUB BOARDING CONTRACT

ORION KENNEL CLUB, (Kennel) and (Owner – please fill in your full name) agree as follows:

Owner will pay the boarding rate in effect on the date the Owner's pet is checked into the Kennel (rate as posted in the office), as well as all costs and charges for special services requested.

Kennel is authorized to release the pet to the Owner or any person designated by the Owner.

Although reasonable care will be taken of the Owner's pet, circumstances may arise in which the Kennel feels it is appropriate or necessary to seek medical attention for the pet. In such cases the Kennel may consult a veterinarian, administer medicine, transport the pet to the nearest emergency care facility, or take any other action deemed necessary by the Kennel. Owner shall pay Kennel for all expenses so incurred.

In case of emergency, it is the policy of the Kennel to make reasonable efforts to contact the Owner as soon as possible.

Although reasonable care will be taken of the Owner's pet, the Owner is solely responsible for any harm the pet may cause in spite of such reasonable care.

Payment is due in full at the time of pick-up of the Owner's pet. The Kennel shall have a lien on the pet to ensure payment, and the Kennel may retain custody of the pet until payment is made in full. If Owner either: fails to make payment in full at the time of pick-up, or fails to pick-up or request delivery of the pet within five (5) days of the estimated date of return, then the Kennel, after giving ten (10) days’ notice by regular mail to Owner, may sell the pet. All proceeds of sale shall belong to the Kennel, unless such proceeds exceed the unpaid charges plus costs of sale, in which event such excess shall be mailed to Owner. If the proceeds of the sale are insufficient to pay Kennel in full for its unpaid charges and costs of sale, Owner shall remain liable for the difference. The Kennel shall advertise the sale by placing a one-day advertisement in a local newspaper, and shall sell the pet to the person who makes the highest offer within the 7-day period after the ad is printed. If no offers of payment are made within the 7-day period, the Kennel may dispose of the pet in any manner it wishes.

Kennel does not assume and shall not be held responsible for any liability with respect to the pet listed in this agreement, of any kind whatsoever, arising out of or from the boarding of this pet, or any damages which may accrue from any other cause whatsoever, including loss by fire, theft, disease, running away, death, injury to persons, animals, or property, or death or injury to any other animal caused by the within named pet during the term of this contract.

It is expressly agreed by Owner and Kennel that Kennel’s liability shall in no event exceed the lesser of the current market value of a pet of the same species or the sum of $500.00 per animal boarded. The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of the Kennel.

Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances and that the pet has not been exposed to distemper, parvo, rabies, or kennel cough within the last 60 days.

This is a binding contract and is effective each time the pet is boarded at the Kennel, unless otherwise agreed to in writing by the Owner and the Kennel. No employee of Kennel has any authority to waive any term in this agreement or to bind Kennel to any oral promise or oral modification of this agreement.

Any controversy or claim arising out of or relating to this contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of his award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.

INDEPENDENT CONTRACTOR CONTRACT (GROOMERS)

Owner will pay the grooming rate in effect on the date the Owner's pet is checked in, as well as all costs and charges for special services requested. The independent contractor (groomer) is authorized to release the pet to the Owner or any person designated by the Owner.

Although reasonable care will be taken of the Owner's pet, circumstances may arise in which the Independent Contractors feels it is appropriate or necessary to seek medical attention for the pet. In such cases the Independent Contractors may consult a veterinarian, administer medicine, transport the pet to the nearest emergency care facility, or take any other action deemed necessary by the Independent Contractors. Owner shall pay Independent Contractors for all expenses so incurred.

Payment is due in full at the time of pick-up of the Owner's pet. The Independent Contractors shall have a lien on the pet to ensure payment, and the Independent Contractors may retain custody of the pet until payment is made in full. If Owner either: fails to make payment in full at the time of pick-up, or fails to pick-up or request delivery of the pet within five (5) days of the estimated date of return, then the Independent Contractors, after giving ten (10) days’ notice by regular mail to Owner, may sell the pet. All proceeds of sale shall belong to the Independent Contractors, unless such proceeds exceed the unpaid charges plus costs of sale, in which event such excess shall be mailed to Owner. If the proceeds of the sale are insufficient to pay Independent Contractors in full for its unpaid charges and costs of sale, Owner shall remain liable for the difference. The Independent Contractors shall advertise the sale by placing a one-day advertisement in a local newspaper, and shall sell the pet to the person who makes the highest offer within the 7-day period after the ad is printed. If no offers of payment are made within the 7-day period, the Independent Contractor may dispose of the pet in any manner it wishes.

Independent Contractor does not assume and shall not be held responsible for any liability with respect to the pet listed in this agreement, of any kind whatsoever, arising out of or from the boarding of this pet, or any damages which may accrue from any other cause whatsoever, including loss by fire, theft, disease, running away, death, injury to persons, animals, or property, or death or injury to any other animal caused by the within named pet during the term of this contract.

It is expressly agreed by Owner and Kennel that Kennel’s liability shall in no event exceed the lesser of the current market value of a pet of the same species or the sum of $500.00 per animal boarded. The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of the Kennel.

Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances and that the pet has not been exposed to distemper, parvo, rabies, or kennel cough within the last 60 days.

This is a binding contract and is effective each time the pet is groomed by an Independent Contractor (Groomer), unless otherwise agreed to in writing by the Owner and the Independent Contractors.

The dollar amount that I list will be used as a gauge to help assist in any medical situation that may arise, if we as the owners are unreachable and/or our contact people are not available. If Orion Kennel Club and medical care persons have to make financial medical decisions the following dollar amount $ is an estimate of money that could be spent.

Any controversy or claim arising out of or relating to this contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of his award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.

Owner:

Date:

By clicking the "Submit" button, you are legally agreeing to the above binding contract.