Sign-up to Secure KennelFirst Insurance
I agree to purchase KennelFirst Healthcare insurance (through PetFirst Heathcare) for $1 per day (per
pet) while my dog(s)/cat(s) is/are using the boarding or day camp services of KennelResorts. (The dollar a
day will be assessed for every day that the pet is in the care of KennelResorts (including partial days). If
my pet’s stay is extended, KennelResorts has my permission to continue the insurance for each
additional day.
Name of pet(s):_____________________
_____________________
Insurance coverage will run from _________________(date) to ____________________(date)
_________________________ ___________ _____
(Signature) (Date) (Time)
| Day Camp Only: By putting my initials in this box, I authorize KennelResorts to secure KennelFirst Healthcare insurance for my dog EVERY DAY that he/she attends Day Camp Services. I can cancel this Day Camp healthcare coverage at any time. Payment of $1 is due each day in which my dog attends Day Camp Please initial here. |
| KennelResorts is acting as the broker for dog/cat insurance with KennelFirst. All determinations related to the payment of claims are made by KennelFirst. KennelResorts assumes no responsibility or liability for payment of veterinary care when an owner secures a KennelFirst policy. |
| Owner's Information Name: _____________________________ Address: _____________________________ _____________________________ City: ____________________ State: ____________________ Zip Code: _____________ Home Phone: (____ )________________ Cell Phone: (____ )________________ Work Phone: (____)_________________ Email Address: ____________________________ |
| Pet's Information (complete for each pet) (Age 8 weeks to the 9th birth date.) Name: _____________________________ Birth Date: ___________/___________/___________ (month) (day) (year) Species: Dog or Cat (Circle One) Breed: _____________________________ Color: _____________________________ Sex: Male or Female (Circle One) |