Please complete all information below then submit this form.


Pet's Name    Date

Owner's Name   Telephone

Mailing Address

City     Zip

Email Address

Breed   Weight  Color Age

Check Appropriate Boxes:   Sex: Male Female       Neutered/Spayed

Veterinarian's Name   Telephone

Emergency Number

What kind of food does your pet usually eat?

Feeding Instructions

Medication Instructions

Special Instructions

What treats can your pet have?

Where does your pet spend his days?
Check Appropriate Box(es):   Inside   Outside   With People    With Dogs:

Where does your pet sleep at home?   Has he/she been boarded before?  

Medical  Check all that apply:
Blind    Deaf     Diabetic     Epileptic     Arthritis     Allergies   Sensitive Stomach

Personality Check all that apply:
Quiet    Fearful    Bites     Aggressive     Digs     Escapes     Fence Climber

 Scared of storms?Yes No  Good with dogs?Yes  No  Good with cats? Yes  No
Good with kids?Yes  No

This is a contract between Adam’s Folly Bed and Breakfast for Pets and the pet owner whose signature appears below (hereinafter called “Owner”)

1. Owner agrees to be solely responsible for any and all acts or behavior and/or damages of pet while it is in the care of Adam’s Folly.

2. If pet becomes ill or if the state of the animal’s health otherwise requires professional attention, Adam’s Folly, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the animal, and the expenses thereof shall be paid by Owner. Would you like a courtesy call made to you prior to a vet office visit if possible?
Yes  No

3. Adam’s Folly is not responsible for lost or damaged toys and bedding. Do NOT leave sentimental items.

4. Owner understands that pictures of the pet may be taken and appear on Adam’s Folly’s website.

5. Do you give Adam’s Folly permission for your pet to comingle with other pets? Yes  No

6. If by some unfortunate and unforeseen event pet dies while in the care of Adam’s Folly, Owner wishes for pet’s remains to be held for Owner    or left with doctor to dispose of

7. Other individuals authorized by Owner to pick up pet are

8. All charges incurred by Owner shall be payable upon pick-up of pet.

9. Owner further agrees that the pet shall not leave Adam’s Folly until all charges are paid. By signing (submitting) this contract and leaving his pet with Adam’s Folly.

10. Even with the best cleaning protocols in place, owner understands that his pet may be inadvertently exposed to contagious illnesses during his stay at Adam's Folly and will not hold Adam's Folly liable.

11. Owner certifies to the accuracy of all information given about said pet. I have read this agreement, understood its terms and signed it freely.

Form will be signed when pet is dropped off.