The Loft
at Fiddler’s Green
3685 Klam Road PO Box 73 Columbiaville, MI 48421
(810) 793-8910
Email: judy@theloft4dogs.com
Information Sheet
Please complete and provide to The Loft prior to your dog’s stay
Dog Information
 Dog’s Name_________________________________________________________________
 Breed______________________________________________________________________
 Age________________________ Sex__________Spay/Neuter (Y/N)___________________
 Rabies________________ Distemper/Parvo/Hepa_____________ Bordatella_____________
o Please present documentation that the above vaccinations are current
 Negative Fecal (within last 30 days?)______________________________________________
Owner Information
 Last Name___________________________ First Name______________________________
 Address____________________________________________________________________
 Phone_______________________________ Email address___________________________
 Phone Number Owner can be reached at while dog is at The Loft (only if different than phone
number listed above___________________________________________________________
Veterinary Information
 Vet Clinic Name______________________________________________________________
 Address____________________________________________________________________
 Phone Number:______________________________________________________________
o
Note: Every effort will be made, if veterinary assistance is necessary, to get your dog to your vet.
However, if your vet is not reachable, or if time is of the essence, The Loft may choose to seek veterinary
assistance from The Loft’s vet.
Dog’s Medical History
 Please list any medical conditions with your dog that we need to be aware of (including heart
condition, thyroid, allergies, seizure, physical limitations, cancer or other medical conditions)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
 Has your dog exhibited any vomiting/diarrhea within the last 2 weeks? __________________
Dog’s Habits/Behavior
 Please tell us about any habits or behavior your dog has that we should be aware of (including
jumping, biting, behavior with other dogs, etc)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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Do you use a regular flea/tick preventative (Y/N)_________ Last Time Dosed __________________
The Loft
at Fiddler’s Green
3685 Klam Road PO Box 73 Columbiaville, MI 48421
(810) 793-8910
Email: judy@theloft4dogs.com
Boarding Contract
Please complete and provide to The Loft prior to your dog’s stay
Pricing Agreement
 $20 per night per dog (all exercise, activities, playtime, administration of medication (if necessary) included )
 Free courtesy transportation to/from home (if stay is longer than 4 nights) provided by The Loft
o Please make arrangements for pick up and drop off time (we are very flexible on pick up & drop off times!)
 Payment due upon your dog’s return back home from each stay (Cash/checks acceptable as payment, please
make checks payable to Judith Greig)
Owner to send along with dog
 Food for your dog’s stay at The Loft
 Feeding instructions (please complete below)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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 If medication needs to be administered to your dog, please provide medication, along with instructions for
administering below:
_________________________________________________________________________________________________
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 Optional: One gallon of water your dog drinks at home (The Loft uses softened well water, and we’d like to
gradually work your dog into drinking our water)
 Optional: Your dog’s bed/your dog’s favorite toys/blanket, etc.
o The Loft provides beds/toys/treats…this is only if your dog prefers his/her own bed!
o Anything sent along with your dog (that is not eaten during your dog’s stay) will be returned with your dog
This is a contract between The Loft at Fiddler’s Green (herein referred to as ‘The Loft’) and the Dog Owner,
whose signature appears below (herein referred to as the ‘Dog Owner’)
1. The Loft shall provide reasonable care for your dog and make it a goal to provide a fun, relaxing and safe
environment for your dog while staying at The Loft.
2. Dog Owner agrees to pay the rate for boarding as specified above
3. Dog Owner agrees to pay any and all veterinary expenses, if necessary, for their dog, that are incurred while
staying at The Loft.
a. The Loft agrees to make every effort to notify Dog Owner in the event such services/charges may be
necessary.
4. If your dog injures another dog while staying at The Loft, Dog Owner is solely responsible for expenses
associated with any injury to the other pet.
a. Dog Owner releases The Loft from any liability for such injury to other dogs.
b. The Loft agrees to exercise reasonable and safe judgment with respect to placing pets together during
playtime. The Loft agrees to provide each dog with individual rest/sleeping/bedrooms and will feed all
dogs separately, unless otherwise requested by Dog Owner (for example, if dogs are from the same
family).
5. Dog Owner agrees that The Loft’s liability for any negligence found shall in no event exceed the sum of $500 per
dog boarded. Dog Owner agrees to hold The Loft harmless against any and all loss, damages or claims above
and beyond this amount.
6. The Loft reserves the right to refuse a dog in the event sufficient documentation cannot be provided on
vaccination history.
7. This contract contains the entire agreement between The Loft and the Dog Owner.
Dog Owner Signature______________________________________________________ Date _________________
The Loft at Fiddler’s Green Representative _____________________________________ Date _________________