Owner Information

Owner’s Name: *

Email *

Contact (Name & Phone):

Home Address:

Home Access instructions ( Gate Code, Door Code, Etc) *

Services Requested

Check-Ins
Overnight Care
Transportation

During time of care what would you like to be completed? Select all that apply: *

Walks
Feed
Medication Administration
Potty Break
Play Time
Custom

If custom, please specify:

Additional Notes:

Pet Information

Pet 1

Name

Breed:

Special Notes / Needs:

Pet Temperament (check all that apply):

Pet 2

Name

Breed

Special Notes / Needs:

Pet Temperament (check all that apply):

Pet 3

Name

Breed

Special Notes / Needs:

Pet Temperament (check all that apply):

Pet 4

Name

Breed

Special Notes / Needs:

Pet Temperament (check all that apply):

Veterinary Information

Veterinarian Name/Clinic

Phone Number:

Address:

Required Vaccinations (Proof Required Before Transport):

Rabies (up-to-date)
Distemper/Parvo (dogs)
Bordetella/Kennel Cough (dogs)
FVRCP (cats)
Other

If selected other (please specify):

Liability & Consent Waiver

I, the undersigned, certify that I am the legal owner/Guardian of the above-named pet(s) and hereby grant permission for Kerbie’s Pet Pick Up & Services to transport and provide care for my pet(s) as agreed.

I understand and agree that:

1.General Release of Liability

Transport and pet care involve inherent risks. My pet(s) will be handled with care and compassion, but I release and hold harmless Kerbie’s Pet Pick Up & Services from any liability, claims, or damages arising from services provided, except in cases of proven negligence.
Kerbie’s Pet Pick Up & Services, its employees, and affiliates are not liable for injury, illness, escape, or death of any pet during or after transit or at home care.

2. Health, Vaccinations & Pre-Existing Conditions

I am responsible for providing accurate information and ensuring my pet is up-to-date on required vaccinations. Kerbie’s Pet Pick Up & Services is not liable for illnesses due to unvaccinated pets or illnesses that occur naturally or from prior conditions.
I acknowledge that Kerbie’s Pet Pick Up & Services is not responsible for any complications, injuries, stress responses, or health issues arising from my pet’s pre-existing medical or behavioral conditions. This includes, but is not limited to, anxiety, respiratory issues, joint or mobility limitations, allergies, seizures, and age-related conditions. I agree to disclose all relevant health information prior to services and accept full responsibility for any related incidents.

3. Transportation Risks, Delays & Weather Conditions

I acknowledge that delays or schedule changes may occur due to traffic, road conditions, weather, emergencies, or circumstances beyond the company’s control. Kerbie’s Pet Pick Up & Services is not liable for inconveniences, extended transport times, or appointment impacts resulting from such delays. The company will communicate changes as promptly as possible.
I understand that weather can affect my pet’s comfort and safety. Kerbie’s Pet Pick Up & Services will take reasonable steps to keep my pet safe, but is not responsible for health issues caused by extreme heat, cold, humidity, or other weather conditions beyond their control. Services may be delayed, adjusted, or rescheduled if the weather is unsafe.

4. Medical Care, First Aid & Emergencies

Kerbie’s Pet Pick Up & Services is not a licensed veterinary provider. Any care, first aid, or decisions made during transport or services are based on best judgment only.

In case of emergency, I authorize the transporter/care taker to seek veterinary care at my expense. Kerbie’s Pet Pick Up & Services is not liable for outcomes or complications resulting from medical treatment.

If a pet experiences a medical emergency while in the care of Kerbie's Pet Pick Up & Services, reasonable efforts will be made to contact the owner and/or the designated emergency contact before authorizing treatment. If the owner or emergency contact cannot be reached and immediate veterinary care is deemed necessary for the health and safety of the pet, Kerbie's Pet Pick Up & Services is authorized to transport the pet to a licensed veterinarian or emergency veterinary facility for treatment.
The client acknowledges and agrees that they are solely responsible for all veterinary expenses, emergency treatment costs, medications, diagnostics, hospitalization, and any related fees incurred. Kerbie's Pet Pick Up & Services assumes no financial responsibility for any third-party veterinary or emergency medical costs.

5. At-Home Check-In Responsibilities

The company is not responsible for pre-existing damage, unsecured areas, or issues within the owner’s home that occur outside of the company’s presence or control.

Kerbie’s Pet Pick Up & Services is not liable for malfunctioning keys, lockboxes, garage doors, or entry systems. I agree to provide reliable access to the home.

I am responsible for providing adequate food, supplies, and clear instructions. The company is not liable for issues resulting from incomplete or unclear information.

6. Behavioral Responsibilities & Pet-Caused Damage

I accept full liability for any damage caused by my pet, including but not limited to damage to vehicles, equipment, property, or injury to other animals or individuals. Kerbie’s Pet Pick Up & Services is not responsible for damages or injuries resulting from my pet’s behavior, temperament, or actions.
Kerbie’s Pet Pick Up & Services reserves the right to refuse or discontinue services at any time if a pet’s behavior, the pet’s environment, or interactions with the pet’s owner create an unsafe, unprofessional, or uncomfortable situation.

7.Transportation Services & Third-Party Payment Responsibility

When Kerbie's Pet Pick Up & Services transports a pet to a veterinarian, grooming appointment, boarding facility, daycare, training appointment, or any other third-party service provider, the client is solely responsible for all fees and expenses associated with those services. This includes, but is not limited to, examination fees, treatments, medications, diagnostic testing, grooming charges, boarding fees, daycare fees, training fees, and any additional services provided.

Clients are responsible for making all payment arrangements directly with the third-party service provider prior to the scheduled appointment whenever possible. Kerbie's Pet Pick Up & Services is not responsible for paying, advancing, guaranteeing, or collecting payment for any third-party services.

If payment has not been arranged and the service provider requires payment before services are rendered or before the pet can be released, Kerbie's Pet Pick Up & Services reserves the right to postpone or cancel transportation until payment has been confirmed. Any resulting delays, cancellation fees, or additional charges remain the client's responsibility.

8. Photo & Social Media Consent:

I understand and agree that photos and/or videos of my pet may be taken during services. I give permission for these photos and/or videos to be used by Kerbie's Pet Pick Up & Services for promotional and marketing purposes, including but not limited to posting on social media platforms, website content, and other business materials. I understand that my pet’s name or identifying information will not be shared without my permission.

9. Pricing, Additional Fees & Policy Acknowledgment

By signing this agreement, I acknowledge that I have read, understand, and agree to the following pricing policies, service fees, and cancellation terms.

Pricing

All service rates are subject to change at any time without prior notice. Any applicable additional fees will be discussed and agreed upon before services are provided whenever reasonably possible.

Business Hours & After-Hours Services

Normal business hours are 7:00 AM to 6:30 PM.

Services scheduled before 7:00 AM or after 6:30 PM are considered after-hours appointments and are subject to an additional after-hours service fee.

Additional fees may also apply for services provided on major holidays or outside of normal business hours.

Cancellation Policy

To allow for proper scheduling and staffing, the following cancellation policies apply:

Transportation Services & Check-In Visits:

A minimum of 24 hours' notice is required for cancellations.
Cancellations made less than 24 hours before the scheduled service will be charged 50% of the scheduled service fee.
Same-day cancellations or no-shows will be charged 100% of the scheduled service fee.

Overnight Services

A minimum of 48 hours' notice is required for cancellations.
Cancellations made less than 48 hours before the scheduled overnight service will be charged 50% of the total overnight booking.
Cancellations made the day of the scheduled overnight service, on the day service is scheduled to begin, will be charged 100% of the total overnight booking.

*Overnight Care*

Overnight care is defined as services provided between 6:00 PM and 7:30AM. If additional check-in visits are requested or required outside of the overnight care period, standard check-in visit fees will apply.

By signing below, I acknowledge that I have read, understand, and agree to these policies and accept responsibility for all applicable service fees, including pricing adjustments, after-hours fees, holiday fees, late cancellation fees, no-show charges, and fees for any additional requested services.

I confirm that I have read, understood, and agree to all terms above.

Owner/Guardian Signature:

Clear

Owner/Guardian Signature:

Date time

Kerbies Pet Pick Up & Services

Owner Information

Pet Information

Veterinary Information

Required Vaccinations (Proof Required Before Transport):

Liability & Consent Waiver

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