Pet Shelter RegistrationsCats & Dogs Only

Pet Shelter Registrations

Cats & Dogs Only

Notes:

Portal will close 2 days prior to storm affecting facilities.

Employee #*

Employee Name*

Department*

Cell Phone #*

Phone

Campus You Work At*

Select

Type of Pet*

Select

Pet Name (One Pet Per Entry)*

Veterinarian Name & Address*

Veterinarian Phone*

Phone

Rabbies Vaccine Date*

DHLPP or FVR Vaccine Date

Bordetella Vaccine Date

Alternate Pick Up Person*

Alternate Contact #*

Phone

What You Must Bring & Do:

Each owner must bring for each pet the following items labeled in a tote or tub, with the owner’s identification:

Pet Crate (note cats need a large enough crate to allow for litter box).
A leash for each dog.
Supplies for a minimum of 3 days.
Food with bowl (non-refrigerated food only).
Bottled water with bowl.
For dog owners, a package of dog pads to allow for indoor urination if weather does not allow access to the outside.
Any medications, with specific instructions (owner is responsible to administer medications). Pet Shelter Volunteers will not be responsible for medication administration, and it is advised that you seek alternate care arrangements if at all possible.
Manual can opener, if needed.
Cat litter, litter scoop, and small litter box(es) –disposable pie pan, baking dish, etc., which will fit in crate for cats.
Plastic bags, cleaning equipment, paper towels, disinfectant, etc.
Light-weight cloth or blanket to cover the crate.
May bring one small familiar item, toy or blanket if room allows in crate.

Each owner must do:

Set up each animal’s crate in the space designated by the Pet Shelter Coordinator or a Pet Shelter Volunteer.
Feed and water pet(s), as work schedule and weather permit.
Exercise your pet(s), as work schedule and weather permit.
Clean up after pet(s) after exercising and upon picking pet up.
Pick up, or have alternative person pick up pet(s) as soon as the team member’s responsibility during the crisis has ended.

Pet Shelter Procedures/Agreement*

I Acknowledge that:

I have read and understand the rules and regulations set forth in the Temporary Pet Shelter agreement.
My pet(s) are up to date on rabies vaccinations.
My pet(s) has no history of aggressive behavior and has not been diagnosed with any contagious diseases for which it has not received successful treatment.
I understand that any decision concerning the care and welfare of my pet and the shelter population as a whole are within the sole discretion of the Pet Shelter Coordinator / SMHCS Volunteer whose decisions are final
I agree to abide by the rules and regulations and accept all the terms, conditions, and statements of this agreement and the policy and procedure.
I understand that I am solely responsible for any harm or damage caused by my pet(s) while my pet(s) are attending the temporary shelter at SMHCS. This includes, but is not limited to, injury to other persons, animals, and property damage.
I understand and agree that in admitting my pet(s), SMHCS has relied on my representation that my pet(s) is in good health and have not harmed or shown aggression or threatening behavior towards any person or any other pet.
I understand and agree that SMHCS, its staff or volunteers, will not be liable for any problems that develop, and I hereby release them of any liability of any kind whatsoever arising from my pet(s) attendance and participation at a SMHCS temporary pet shelter.
SMHCS is not guaranteeing attendant availability in the shelter at any time during the emergency. Such availability is strictly on a volunteer basis and will not be the responsibility of SMHCS.
I understand and agree that if any problem develops with my pet(s), the available volunteers will first attempt to contact me to personally deal with the issues. If they are unable to contact me, then the problem will be treated as deemed best by volunteers of SMHCS, in their sole discretion.
I assume full financial responsibility for any and all expenses involved, including any veterinary charges.

Upload Proof of Vaccination(s) Below:

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Acknowledgement*

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