Pet Personality Profile

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1 Pet Personality Profile Owner s Information Last Name: First Name: Phone: (cell) (home) (work) Emergency Contact Name: Phone: Pet s Information Name: Breed: Color: Sex: M F Spayed/neutered? Yes No Birth date: Age: Weight: Veterinarian s Name: Clinic Name: Clinic Phone: Clinic Address: In the event of an emergency, if all reasonable attempts to contact your primary veterinarian are unsuccessful, reserves the right to transport your dog to an emergency veterinarian. How did you hear about us? Behavior and Health Information Has your dog been socialized with other dogs? Yes No Has your dog been socialized with other people other than family members? Yes No Does your dog jump fences? Yes No Describe circumstances: Is your dog crate trained? Yes No Has you dog been vaccinated for parvo/distemper and rabies? Yes No Are your dog's vaccinations current? Yes No Owners are required to provide proof of current vaccinations, or results of a titer test showing immune system coverage (distemper, parvovirus & rabies). Bordatella Vaccinations are OPTIONAL IF DOG RECIVES ORAL VERSION OF THIS VACCINE HE/ SHE MUST STAY OUT OF THE FACILITY FOR 10 DAYS. Does your dog need to be given medications? Yes No Instructions: Are there any restrictions to be placed on your dog's activities and movements? Yes No Instructions: Does your dog have food allergies? Describe: Is there anything else you want to share that would be helpful for our staff?

2 We, at, strive to care for your dog in the cleanest, healthiest environment possible, but just like in a child's school environment, sometimes illness and accidents happen. By signing below, you acknowledge that we will do our best to keep your dog safe and healthy and also hold us harmless from illness and/or accidents regarding your dog. Signature: Date: Office Use Only Date of dog's first day in daycare: Rules, Regulations, & General Information Age: Dogs enrolled in day care must be old enough to have had no fewer than two vaccines each for parvo and distemper, or nosodes for parvo/distemper. Sex: All dogs are eligible to attend our daycare, regardless of sexual status except for those currently in heat. Vaccinations: Owners are required to provide proof of current vaccinations (distemper, parvovirus, rabies). Bordatella vaccinations are optional. Health: All dogs must be in good health; owners will certify their dog(s) are in good health and have not been ill with a communicable disease within the last 30 days. Upon enrollment, all dogs must be free from any condition that could potentially jeopardize the health or safety of other clients. Dogs who have been ill with a communicable disease in the last 30 days will require a veterinarian's certification of health to be admitted or re-admitted. No dogs will be allowed to attend day care with visible stitches or bandages. Behavior: Generally, all dogs must be non-aggressive and not overly food or toy protective. Should your dog exhibit any behaviors deemed unsafe during their enrollment in our daycare program, staff will have authority to remove your dog from its daycare program permanently. Please remember your dog(s) will be spending time with other dogs and the safety, health, and enjoyment of all clients is our primary concern. We do work with some dogs with problematic behaviors, who may require additional training at additional cost. Application and Agreement: All dogs must have complete, up-to-date, and approved Application and Pet Personality Profile and Client Agreement forms on file.

3 There are no cash refunds. Refunds will be in the form of exchange for other services; grooming, retail, or training. Business Hours Monday through Friday, 7:00 a.m. To 7:00 p.m. Saturday, 8 a.m. to 5 p.m. Closed holidays. Reservations Please call to reserve your spot! Payment We accept cash, checks, and all credit cards. Payment due at time of pick-up. Bank returned checks require cash payment of enrollment fees plus $35 to cover bank charges to. I have read and agree to the above and signing that I agree... Owner's Name (please print) Signature: Date: Client Agreement 1. I understand that I am solely responsible for all harm and damages caused by my dog(s) while he/she is attending daycare, classes, or any other services provided by. I further understand that if there is an incident between dogs that result in the need for medical attention, each owner is solely responsible for their own veterinary bills relating to the incident. Initial 2. I agree to inform of all risks associated with my dog that are known to me, or that should be known to me, whether or not such risks are specifically asked about on the Pet Personality Profile. If I fail to inform of such risks, I understand that I am responsible for all losses or damages caused by my failure to properly inform. 3. I shall indemnify and hold harmless against any and all claims, demands, damages, and costs, including attorney's fees, made against it based on injury or damages caused by my dog while in the care of. 4. I further agree to indemnify and hold harmless from damages and injury caused to myself, or others that accompany me onto 's premises, provided reasonable care and precautions are taken by. I agree not to leave children unattended at. 5. I hereby release from any liability, claims, demands, damages, and costs, including attorney's fees, of any kind, known or unknown, arising from my dog's attendance and participation at the daycare, over care, classes or other services. 6. I further understand and agree that any problem that develops with my dog(s) will be treated as deemed best by staff in their sole discretion, and I assume full financial responsibility for any and all expenses involved. I recognize and understand that if my dog(s) becomes ill, or if the state of the dog's health otherwise requires professional attention,, at its sole discretion, may engage the services of any veterinarian of 's choice, may administer medicine, and may give other requisite attention to the dog. I thereof shall pay all expenses and I expressly authorize, by signature below, that all such charges for medical services will become my responsibility.

4 7. I further understand and agree that in admitting my dog(s) to, the facility has relied upon my representation that my dog(s) is/are in good health and have not been ill with any communicable condition in the last 30 days. I further certify that I have informed about any and all past incidents wherein my dog has harmed, threatened, or behaved aggressively towards any persons or other dogs. 8. I have initialed each statement below to acknowledge my understanding and acceptance: A. I recognize that there are inherent risks of illness or injury when dealing with animals. Such risks include but are not limited to, illness due to sharing toys or common water bowls, problems resulting from rough play such as soreness or stiffness, ingesting unknown foreign objects, and/or uncontrolled animals outside our facility. B. I recognize that there is an inherent risk of fighting or disease transmission, resulting in possible injury or death, when commingling dogs from different backgrounds, with different temperaments, different medical and treatment histories, who are owned by different individuals. C. I agree that each owner is solely responsible for any injuries or veterinary bills that may result from an incident between dogs.. D. In event of emergency, I give permission to take my dogs off site, as deemed appropriate and necessary by staff members. E. I certify that I have read and understand the rules and regulations set forth by and have read and understand this agreement. I agree to abide by the rules and regulations and accept all terms, conditions, and statements of the agreement. THIS IS A WAIVER OF LIABILITY, READ BEFORE SIGNING! Dog s Name(s) and Breed(s) Owner s Name(s) (please print) Owner s Signature Date Phone Number Address: Staff Member s Signature Date Rates & Fees Daycare One Full Day (7:00-7 M-F, 8-5 S) $31 One Full Day, Second Dog $21 Day Care Passes 5 Full Day $29 per day ($145 + tax)

5 10 Full Day $28 per day ($280 + tax) 20 Full Day $27 per day ($540 + tax) 30 Full Day $25 per day ($750 + tax) One Half Day (5 hours or less) One Half Day, Second Dog $22 per day $19 per day Half Day Passes 5 Half Day $21 per day ($105 + tax) 10 Half Day $21 per day ($210 + tax) 20 Half Day $21 per day ($420 + tax) 30 Half Day $21 per day ($630 + tax) Late Pickup $20 charge for late pickups Crates Regular Suite Large Suite Zen Boarding $55(+tax) per $60 (+tax) per $65 (+tax) per $85 (+tax) per Training 15 Minute Walk $5.00(+tax) 30 Minute Walk $10.00(+tax) In-House 30 Minutes Off-Site And many other options! $25.00(+tax) $60.00(+tax) Just let us know what you need help with. I have read and agree to the above and signing that I agree... Owner's Name (please print) Signature: Date:

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