Compassionate Board Form

Animal’s Name_________________ Log Number_____________ Staff Name_____________

Breed of animal_________________ Age of animal____________ Color_________________

Owner’s Name: ____________________________ Home phone: (____)_____________

Address: ____________________________ Alternate phone: (____)_____________

City ________________________ Prov. ______ Postal Code: __________________

Email address _______________________

I, the owner of the animal described above, hereby request that the BC SPCA provide compassionate board for this animal for a maximum two week period. I agree to pay as much of the boarding, vaccinating, deworming, and parasite treatment costs as I am financially able. I further agree that if I have not reclaimed this animal within two weeks and have not provided the BC SPCA with a written explanation for this failure to reclaim, I thereby unconditionally surrender this animal to the BC SPCA.

I understand that the BC SPCA shall accept no responsibility for the present or future health of this animal and no responsibility for any action(s) of the animal while in its care.

Owner’s Signature ________________________________ Date: _____________________