Permission to Vaccinate Permission to Vaccinate Name(Required) First Last Phone(Required)Dog/Cat NameVaccines Due:Canine Selection Rabies – $54.50 Canine Distemper Combination – $54.75 Bordetella – $54.75 Canine Influenza – $75.75 Feline Selection Rabies – $87.25 Feline Distemper Combination = $54.25 Primary Care Veterinarian for Records Exchange(Required)I acknowledge that Kenwood’s Canine Clubhouse requires that my pet is current on the following vaccines for admission: Canines – DHPP (Canine Distemper Combination), Rabies, and Bordetella (“kennel cough”), Canine Influenza Felines – Rabies, FVRCP (Feline Distemper Combination) I authorize Kenwood’s veterinarians to administer any vaccines necessary for boarding admission unless otherwise medically indicated by my pet’s medical history. I acknowledge that there will be a veterinary exam charge of $40.00 for administering any vaccines and monitoring for post-vaccine reaction. This brief exam is NOT a substitute for a thorough annual physical exam and consultation.Signature(Required)Date(Required) MM slash DD slash YYYY CAPTCHA Δ
