Client Service Agreement This is an agreement between you, the client, and Upper Valley Pet Care, L.L.C. which states you are contracting us and our professional pet sitters to provide services for you and your pet. You have read and accepted the Policies and Procedures and agree to pay all pet sitters in a timely manner.Please enable JavaScript in your browser to complete this form.Application Date (MM/DD/YYYY): *Client's Name: *FirstLastAddress: *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome Phone #: *Cell Phone #: *I hereby grant permission to the Upper Valley Pet Care, L.L.C. and their agent to provide pet care for the following animal(s): *PLEASE LIST THE NAMES OF YOUR PETSEMERGENCY CONTACTSPlease provide three if possibleName: *FirstLastRelationship: *Phone: *Address: *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDoes this person have access to your home? *YesNoCould this person take charge of your pet(s) in an emergency? *YesNoName:FirstLastRelationship:Phone:Address:Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDoes this person have access to your home?YesNoCould this person take charge of your pet(s) in an emergency?YesNoName:FirstLastRelationship:Phone:Address:Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDoes this person have access to your home?YesNoCould this person take charge of your pet(s) in an emergency?YesNoI attest that I am the legal owner of said pets. UVPC and their agent will be given access to my home and property for care of said pets. This includes routine scheduled visits and any emergency that may arise while the pets are under care of UVPC.I have read and agree to the UVPC Policies and Procedures.Intake and feeding information has been provided for each pet and any special needs or concerns have been disclosed to the pet caregivers.I agree to inform UVPC of any changes in behavior or health of said pet(s) that may affect the care of said pet(s), the health and safety of the pet caregiver and other persons or animals.I hereby give my consent to the representatives of the UVPC to photograph, film and or tape and then use and publish the same in print and/or electronically and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and online platforms.Emergency contacts have been provided.In the event that any pet care or emergency contact updates are needed, I agree to inform UVPC in a timely fashion.UVPC will exercise all due and reasonable care to prevent injury, illness to my pet and property. However, in the event of illness, injury or any loss or damage to pets or property, UVPC and their agents will not be held personally liable for such injury, illness, damage, or any loss.Client Signature: *FirstLastEmail *Date / Time: *DateTimeDo you have a UVPC pet sitter already assigned? *YesNoIf yes, please list their name(s)CommentSubmit