Liberty Acres Pet Resources New Client Registration Form

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Liberty Acres Pet Resources is so honored to keep your pet(s). Thank you for the privilege. We offer many services including: boarding, farm/home visits, and doggie daycare. Your fur kid(s) are in good hands and they will beg you for a return visit. We are also able to administer medicine if your pet requires it. In order to stay at Liberty Acres, your pet(s) must be current on rabies, annual, and bordatella vaccines. They must be non aggressive towards people and other dogs. Flea and tick free and for new clients, have a negative fecal test from vet within the past 6 months. We must see or get a copy of current vet records annually. We cannot accept any pet without proper vet documentation. When you bring your pet(s) for the stay, be sure to bring food and meds. We supply bedding, bowls, treats and toys. If you bring any additional items, please put your name on as many items as possible, or include a list of items to ensure everything returns back! Current overnight rates are $30 nightly for first dog. Additional $5 nightly fee will be applied for un fixed dogs (over 6 months). Additional dogs are $20 nightly each. We accept cash, check, and Venmo at this time. NO CARDS. First time stays are due at drop off. Cancellations will be $25 per dog if not canceled before 48 hours of stay. Hours M-F 8am-6pm Sat 8am-6pm Sunday 9am-1pm and holidays closed Please fill out as much info on this form as possible. There is a waiver to print as well. If you don't have a way to print, we have a waiver ready for you in the office at drop off! Please complete the forms below to your fullest extent. We will contact you if additional information is required. John & Ann Langle, Liberty Acres

Owner Information

First Name *Required*

Last Name *Required*

Phone Number *Required*

Email *Required*

Address

City

State | Province

Zip Code | Postal Code

Family Vet Clinic

How did you find us?

Emergency Contact (Include Phone Number)/Others Allowed to Pick Up

Pet #1 Information

Pet Name *Required*

Breed (Best Guess) *Required*

Sex *Required*

Color Description

Date of Birth

Liberty Acres Pet Resources requires proof of vaccination.

Rabies Expiration

Annual Boosters Expiration

Bordetella (kennel cough) Expiration

Dewormed Expiration

--- Expiration

Microchip Code

Weight

Insurance Info

Feeding Notes

Medication Notes

Temperament Notes (Aggression, anxiety, etc? If extensive, tell us in person).

Additional Notes (Anything else we should know? If extensive, tell us in person.)

Pet Question #1: How does your dog react around other dogs?

Pet Question #2: Does your dog have storm or firework anxiety?

Pet Question #3: Does your dog do well in a kennel overnight?

Pet Question #4: Can your dog climb fences, dig a lot, or have other escape tendencies?

Pet Question #5: What is your pet's feeding and medicine details? (Amount, frequency, times)

Mobile Phone Alert: Some phones have difficulty uploading the files below (the form gets reset after uploading). If this happens on your phone, please submit this form using a computer. You can also submit this form on your phone without uploading anything and then email your pet picture and vaccine verification document to us at libertyacres501@gmail.com. Thanks!

Pet Photo (Not Required. 5MB Max. Image Files Only)
Click to Upload Pet Picture

Proof of Vaccinations (5MB Max. Only Images, No PDFs. Take a Picture of Document with Your Phone and Upload It.)

Click to Upload a Picture of Proof of Vaccinations

Click Here to Add a Second Pet

Click Here to Add a Third Pet

ALERT: If you have more than three pets, submit this form once with your first three pets. After submitting the first time, click the link to come back to the form (shown after you submit the form) and fill out this form again with the information for your other pets. The second time you fill it out, you only need to include your name, phone and email in the OWNER section because the business will already have the other info (address, emergency contact, etc) from the first time you submitted the form.

Pet #3 Information