AllBreed s Canine Care Application

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1 AllBreed 2357 Ventura Drive, Ste 102 Obedience & Woodbury, MN Behavioral school for dogs AllBreed s Canine Care Application 651/ em: Aobedience.aol.com PLEASE PRINT DATE: Name: Home phone Work Phone Address:: City State Zip Address: Voice Mail? EMERGENCY CONTACT INFORMATION: Name: Phone #(s) Address: PET INFORMATION: Dog s Name Breed Sex of Birth Enrollment Age Weight: Is your dog altered? (spayed/neutered) Yes No has your dog taken an obedience class? If yes, to what level Obedience Training commands: VETERINARIAN INFORMATION: Clinic Name: Veterinarian s Name:_ Address: Phone Number: _

2 Page -2- Dog Profile: This profile will help the staff better prepare for your dog s particular needs during his/her day at our Canine Care program. The information is strictly confidential and will not be shared with anyone else. Are you having problems in any of the following areas: Play biting Jumping Counter Cruising Housebreaking Aggression towards other dogs Aggression towards people Shy Barking (excessive) Chewing Digging Separation Anxiety Sharing Toys with other dogs Fence Jumping crate training Other: Health Issues: Are there any physical restrictions or issues (i.e. hip displasia) that we need to be aware of? If yes, what are they? Is your dog currently on any medicine? If so, what is it and what is the dosage and dosing times? Does your dog have any allergies to food, etc. that we need to be aware of? If yes, what are they? *PEOPLE AUTHORIZED TO PICK UP YOUR DOG 1. Name Phone # 2. Name Phone # *We will be asking for photo I.D. if someone other than yourself is not picking up the dog. I have filled this application out to the best of my knowledge:

3 AllBreed s Copy Owner Agreement I,, hereby certify that my dog(s) is/are in good health and has/have not been ill with any communicable condition in the last 14 days. I further certify that my dog(s) has/have not harmed or shown aggressive or threatening behavior towards any person or other dog. By checking the box by each statement show that I have read and understand the following:! I understand that I am solely responsible, including financially, for any harm caused by my dog(s) while my dog(s) are attending.! I further understand and agree that in admitting my dog(s) to this program, AllBreed s Canine Care staff have relied on my representation that my dog(s) is/are in good health and has/have not harmed or shown aggressive or threatening behavior towards any person or dog.! I further understand and agree that AllBreed Canine Care and their staff will not be liable for any problems that develop, provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising my from my dog(s) attendance and participation in the program.! I further understand and agree that dogs can sometimes receive minor cuts and scratches at daycare and any problems that develop with my dog(s) will be treated and deemed best by the staff of AllBreed s Canine Care program, at their sole discretion, and that I assume full financial responsibility for any and all expenses involved.! I further understand that if my dog is aggressive to other dogs, he/she will not be allowed to participate in group play, but will have ample opportunity for one on one interaction with the staff.! I further understand that my dog must be friendly with people. Dogs that are aggressive towards people will not be accepted into AllBreed s Canine Care program.! I further understand my dog must be leashed for drop offs and pick ups.! I agree to keep AllBreed Canine Care informed of any changes of the above! I understand and agree to the cancellation policy set forth in the general information. I have checked and read the above statements and agree as they are set forth

4 Owner s Copy Owner Agreement I,, hereby certify that my dog(s) is/are in good health and has/have not been ill with any communicable condition in the last 14 days. I further certify that my dog(s) has/have not harmed or shown aggressive or threatening behavior towards any person or other dog. By checking the box by each statement show that I have read and understand the following:! I understand that I am solely responsible, including financially, for any harm caused by my dog(s) while my dog(s) are attending.! I further understand and agree that in admitting my dog(s) to this program, AllBreed s Canine Care staff have relied on my representation that my dog(s) is/are in good health and has/have not harmed or shown aggressive or threatening behavior towards any person or dog.! I further understand and agree that AllBreed Canine Care and their staff will not be liable for any problems that develop, provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising my from my dog(s) attendance and participation in the program.! I further understand and agree that dogs can sometimes receive minor cuts and scratches at daycare and any problems that develop with my dog(s) will be treated and deemed best by the staff of AllBreed s Canine Care program, at their sole discretion, and that I assume full financial responsibility for any and all expenses involved.! I further understand that if my dog is aggressive to other dogs, he/she will not be allowed to participate in group play, but will have ample opportunity for one on one interaction with the staff.! I further understand that my dog must be friendly with people. Dogs that are aggressive towards people will not be accepted into AllBreed s Canine Care program.! I further understand my dog must be leashed for drop offs and pick ups.! I agree to keep AllBreed Canine Care informed of any changes of the above! I understand and agree to the cancellation policy set forth in the general information. I have checked and read the above statements and agree as they are set forth

5 Owner; s copy General Information and Policies Our goal at is to provide a well balanced, socially stimulating and healthy environment for your dog. To ensure the safety and health of your pet and our other guests, compliance with the following rules and regulations are required. AGE: SEX: SHOTS: HEALTH: All dogs must be at least 12 weeks of age or older All dogs seven month or older must be spayed or neutered (unless there is prior authorization) All dogs must have up to date vaccinations. Owners must submit written proof Of Rabies, DHLPP and Bordatella. During the months of March 1 through December 1, dogs must be on a flea and tick prevention. All dogs must be in good health. Dog s coming in with diarrhea, vomiting or Ill health will be separated from group play until owner can come and get them. If owner cannot be contacted, and dog needs immediate veterinarian care, owner Agrees to allow AllBreed Canine Care to take the dog to our on-call veterinarian, Carver Lake Vet Center. ON CALL VET: Carver Lake Veterinarian Center, 2201 Ventura Drive, Woodbury, MN FEES: Fees are based on attendance. Full day (over 5 hrs) $32 per day. Multiple days in 1 week: $29 per day. Half day (5 hours or less) $18.00 per day. A late pickup charge of $10 for the first 15 minutes late, and $1 per minute passed 15 minutes. Returned checks will be assessed with a $35 additional fee. DAYS & HOURS: Open Monday thru Friday 6:00 a.m. 5:30 p.m. RESERVATIONS: Attendance is valid by reservation only. Drop-ins available if space allows. CANCELLATIONS: Cancellation with less than 24 hours notice will be charged full fees. BAD WEATHER CLOSING: A message will be put on Michael s cell phone if we are closing ( ). It is your responsibility to call before you drive to the center to drop off your dog. I have read the above statements and agree as they are set forth

6 AllBreed s Copy General Information and Policies Our goal at is to provide a well balanced, socially stimulating and healthy environment for your dog. To ensure the safety and health of your pet and our other guests, compliance with the following rules and regulations are required. AGE: SEX: SHOTS: HEALTH: All dogs must be at least 12 weeks of age or older All dogs seven month or older must be spayed or neutered (unless there is prior authorization) All dogs must have up to date vaccinations. Owners must submit written proof Of Rabies, DHLPP and Bordatella. During the months of March 1 through December 1, dogs must be on a flea and tick prevention. All dogs must be in good health. Dog s coming in with diarrhea, vomiting or Ill health will be separated from group play until owner can come and get them. If owner cannot be contacted, and dog needs immediate veterinarian care, owner Agrees to allow AllBreed Canine Care to take the dog to our on-call veterinarian, Carver Lake Vet Center. ON CALL VET: Carver Lake Veterinarian Center, 2201 Ventura Drive, Woodbury, MN FEES: Fees are based on attendance. Full day (over 5 hrs) $32 per day. Multiple days in 1 week: $29 per day. Half day (5 hours or less) $18.00 per day. A late pickup charge of $10 for the first 15 minutes late, and $1 per minute passed 15 minutes. Returned Checks will be assessed a $35 additional fee. DAYS & HOURS: Open Monday thru Friday 6:00 a.m. 5:30 p.m. RESERVATIONS: Attendance is valid by reservation only. Drop-ins available if space allows. CANCELLATIONS: Cancellation with less than 24 hours notice will be charged full fees. BAD WEATHER CLOSING: A message will be put on Michael s cell phone if we are closing ( ). It is your responsibility to call before you drive to the center to drop off your dog. I have read the above statements and agree as they are set forth

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