Reservation Form - Dog Runner Pet Transport, LLC.

The liability of Dog Runner Pet Transport, LLC is limited to the transport fee in the event of death or injury to the below described transport animal or animals. By submitting this form, I agree to these conditions. No puppies less than 10 weeks of age will be accepted for transport. Puppies must have completed 2 rounds of shots no less than 48 hours prior to boarding.

Name & contact phone number of individual completing this reservation form: *

Pick up Date: *

Sending Rescue or Adopter Name: *

City and State: *

Phone Number: *

E-mail Address: *

Pickup Location: *

Required Signature @ pickup:

Receiving Rescue or Adopter Name: *

City and State: *

Phone Number: *

E-mail Address: *

Drop off Location: *

Required Signature upon delivery:

Passenger Information (may be used for multiple animals such as litters or single pickup with single drop off point)

Number of animal(s) *

Name *

Breed *

Sex *

Color *

Approximate Age *

Approximate Weight *

Vaccinations: *

Rabies Vaccination ( Required by Law )	Not old enough for Rabies vaccination	USDA Health Certificate ( Required by Law )	Others are up to date(required by DRPT)
2 Series of shots puppies only(Must be 10 weeks of age for transport)	Spayed/neutered

Payment Summary *

PayPal (Acct name: DogRunnerTport@aol.com)

Check/Money order

Cash

Responsible Party: *

Sending Party

Receiving Party

Payment Timeline *

Prepaid

Upon Delivery