Chasin’ Pets Dog Walking Application
Dog’s Name ______________________________ WEIGHT __________
Date of Birth ___/___/_____
MALE
FEMALE
Breed _____________________________________________________________
Spayed/Neutered?
YES
NO
WHEN? ___/___/_____
Primary Owner’s Name ____________________________________
Home Address ________________________________________________
City _______________________
Zip ______________________________
Day Phone ____________________ Evening Phone ______________________
Email Address ____________________________________________________
How did you hear about us? __________________________________________
Veterinarian ______________________ Phone ______________________
Has your dog had any of the following communicable diseases/conditions in
the past 60 days? Circle all that apply.
Kennel Cough
Mange
Oral Papillomas
Parvo Virus
Conjunctivitis
Diarrhea
Ear Mites
Blood in stool or urine Worms (type) _______________________
Please have an up-to-date vaccination test showing antibodies to the following:



Fleas
Distemper/Parvo (YES or NO) __________________________
Bordatella (YES or NO) ________________________________
Rabies (YES or NO) ___________________________________
Are there any medical conditions we should be informed of?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
EMERGENCY CONTACT NAME ___________________________________
Phone _______________________
Phone ___________________________
Dog Behavior
Please circle all that best describe your dog’s temperament:
Laid Back
Playful
Excitable
Shy
Dominant
Aggressive
Other _________________________________________________
Has your dog ever bitten another animal or person? If yes please describe situation.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please provide additional information you feel necessary to ensure the well-being of your
dog and others.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Terms and Conditions
1. Relationship and Responsibilities
1.1 It is expressly understood that the Owner retains the services of the Walker as an
Independent Contractor and not as an employee. The Walker shall be responsible for
his/her insurance and all statutory declarations and payments with regard to income tax
and VAT where applicable.
1.2 The Walker undertakes to perform the agreed-on services in an attentive, reliable and
caring manner and the Owner undertakes to provide all necessary information to assist in
the performance.
1.3 The Walker undertakes to notify the Owner of any occurrence pertaining to the dog
which may be relevant to the care and well-being of the dog.
1.4 The Walker will supply and be equipped with a scooper and waste bags and will duly
remove the dog’s feces from all public places.
1.5 The Walker reserves the right to walk ONE other compatible dog at the same time.
1.6 The Owner will provide suitable harnesses, collars and leads as approved by the Walker
as well as coats or muzzles if required.
1.7 The Walker shall not be obliged to perform any other duties except those specified on the
Owner’s Information sheet and Pet information sheet.
1.8 You are responsible for informing us of any and all incidents or tendencies of aggression
concerning your dog. Failure to do so may result in immediate termination of this
contract.
2. Compensation
2.1 The Walker shall be paid the amount of $_______ (________________ USD) per walk.
2.2 In the event a collection effort is necessary, past-due accounts will be charged 10% per
year or the highest legal interest rate whichever is greater. Upon referral of a past-due
account to our attorneys, or if law suit or prejudgment attachment proceeding is instituted by
our attorneys, the Owner agrees to pay actual attorney’s fees incurred, court costs, and
expenses including post judgment proceedings.
3. Cancellation or Early Termination
3.1 Either party may terminate this Dog Walking contract a minimum of 24 (twenty four)
hours prior to the first scheduled visit without incurring penalties of damages.
3.2 Cancellation by the Owner of scheduled walks with less than 24 hours notice may be
charged at the full rate or rescheduled at the discretion of the Walker.
3.3 Where the Walker as sole proprietor needs to cancel a scheduled walk due to unforeseen
circumstances, he/she may appoint a substitute Walker with written approval of the Owner
and any difference in the fees charged shall be for the account of the Walker.
3.4 Should any dog become aggressive or dangerous, the Walker may terminate this Dog
Walking contract with immediate effect.
3.5 Any wrongful or misleading information in the Owner’s Information of Pet Information
sheets may constitute a breach of terms of the Dog Walking contract and be grounds for
instant termination thereof.
3.6 Termination under the circumstances described in 3.4 or 3.5 above shall not entitle the
Owner to any refunds nor relief of any outstanding payments due.
4. Liability
4.1 The Walker will carry liability insurance relative to the services performed for the
Owner. A copy of the insurance policy has been made available to the Owner and the Owner
acknowledges that he/she is familiar with its content.
4.2 The Walker accepts no liability for any breach of security or loss of or damage to the
Owner’s property if any other person has access to the property during the term of this
agreement.
4.3 The Walker shall not be liable for any mishap of whatsoever nature which may befall a
dog or caused by a dog who has unsupervised access to the outdoors.
4.4 The Owner shall be liable for all medical expenses and damages resulting from an injury
to the Walker caused by the dog as well as damage to the Owner’s property if any.
4.5 The Walker is released from all liability related to transporting dog(s) to and from any
veterinary clinic or kennel, the medical treatment of the dog(s) and the expense thereof.
5. Whole Agreement
This Dog Walking contract and Owner’s Information sheet, Pet Information sheet(s) and the
Veterinary Release Form attached constitute the sole and entire agreement between parties
with regard to the subject matter hereof and the parties waive the right to rely on any alleged
expressed or implied provision not contained therein. Any alteration to this agreement must
be in writing and signed by both parties. The Owner acknowledges that these terms and
conditions have been read and understood, agrees to be bound by these terms and conditions
and that this agreement supersedes all other proposals oral or written and all other
communications between the parties relating to the subject matter hereof, prior or future, to
the extent same conflict with these terms and conditions.
Signed on this _____ day of ___________________ 20____ by the Owner who warrants
his/her authority to enter into this agreement.
Signed at on this _____ day of ___________________ 20____ by the Chasin Pets authorized
representative who warrants his/her authority to enter into this agreement.
RELEASE OF LIABILITY
I/WE AGREE TO PAY PROMPTLY, IN FULL, AT TIME OF PICK UP OF
SAID PET, AND ANY CHARGES INCURRED BY CHASIN’ PETS.
I/WE ALSO GIVE PERMISSION TO ANY VETERINARY CARE CENTER
OF CHASIN’ PET’S CHOICE TO TREAT OUR PET AS DEEMED
NECESSARY FOR THE PET’S HEALTH AND WELL-BEING AND WILL
BE SOLEY RESPONSIBLE FOR PAYMENT OF ANY CHARGES
INCURRED FOR SUCH CARE AND TREATMENT.
I/WE CERTIFY THAT ALL OWNERS OF SAID PET NAMED ON THE
FRONT OF THIS AGREEMENT ARE LISTED AND HAVE READ, AND
FULLY UNDERSTAND THE MENTIONED TERMS AND CONDITIONS
AND AGREE TO RELEASE CHASIN’ PET’S OWNERS, AND
EMPLOYEES FROM ALL LIABILITY SHOULD ANY ILLNESS OR
INJURIES, MILD OR SEVERE, BE INFLICTED UPON OR SUSTAINED
BY MY/OUR PET WHILE IN CARE OF CHASIN’ PETS.
MY/OUR SIGNATURES ON THIS FORM ARE PROOF OF OUR
ACCEPTANCE TO ALL OF THE TERMS AND CONDITIONS ABOVE
AND THE RELEASE OF LIABILITY CLAUSE. SIGNATURES ARE
REQUIRED BEFORE ANY SERVICES WILL BE RENDERED BY
CHASIN’ PETS. THIS AGREEMENT HAS NO TIME LIMIT AND IS
VALID AND ENFORCABLE FOR ANY AND ALL FUTURE SERVICES
FOR OUR PET(S) WITH CHASIN’ PETS.
Signed on this _____ day of ___________________ 20____ by the Owner who warrants
his/her authority to enter into this agreement.
Owner(s) Signature(s)____________________________________