This form states that individuals who are authorized to pick up the dog when the owner is unable to do so.  This form must be included with your enrollment application.  


Owner Name ___________________________________ Phone ___________________

Dog(s) Name: ______________________________ Breed(s)______________________

Authorized persons

Name __________________________________  

Home Phone ____________________________

Cell Phone ______________________________

Relation to you ___________________________

Name __________________________________  

Home Phone ____________________________

Cell Phone ______________________________

Relation to you ___________________________

Name __________________________________  

Home Phone ____________________________

Cell Phone ______________________________

Relation to you ___________________________

I give permission to the above stated individuals to pick up y dog in my absence.  I also understand that I must call Pet Palace Resort & Spa ahead of time and give them the pass code to authorized this action.                   Pass Code ____________________

Owner Signature: _______________________________ Date _____________________
Pet Palace Resort & Spa
Absent Owner Treatment Consent Form

To be filled out by the owner and used in case their pet(s) needs emergency care while staying at Pet Palace Resort & Spa.

Owner Name_________________________________ Phone # ____________________

Address ______________________________ City_____________ ST_____ Zip______

Contact Phone Number(s) while you are away
(______)________________________      (______)________________________

Please check one of the following statements:
(     )  Pet Palace Resort & Spa is responsible for my pet(s) while I am away and will be able to make all decisions regarding veterinary care.
(     ) Pet Palace Resort & Spa is responsible for my pet(s) while I am away.  For decisions regarding veterinary care, I wish to be contacted.  If I cannot be reached, I appoint the following person to act on my behalf.  

Name________________________________  
Phone # ____________________________

Finances

(       ) I authorize any amount necessary for the treatment of my pet

(       ) I authorize a maximum of $___________ to be used towards my pets’ care.  

Owner Signature_______________________________ Date __________________