Bed & Biscuit, Inc. Doggie Daycare and Boarding. Name: Address: City: State: Zip Code: Home Phone #: Work #: Cell #

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1 Doggie Daycare and Boarding FOR OFFICE USE ONLY Enrollment Form Shots Staff Screened Computer Entry Folder Made First Day EMERGENCY CONTACT INFORMATION Owner Information Name: Address: City: State: Zip Code: Home Phone #: Work #: Cell # Emergency Contact Name: Home Phone #: Work #: Cell # Dog 1 Information Name: Breed: Sex: Birth date: Weight: Dog 2 Information Name: Breed: Sex: Birth date: Weight: Veterinarian Name: Address: Phone:

2 Pet Personality Profile General Information Owner s Last Name: How did you hear about Bed & Biscuit, Inc.? Dog's Name: Date you acquired dog: Dog's breed, sex and age: Is dog spayed/neutered? Where did you get your dog? If adopted, do you have any knowledge of your dog's past history? Does your dog like children? How does your dog behave around children? Are there other animals in your household? If so, please list type, sex and age of each: How does your dog get along with other resident animals? Health/Grooming Does your dog have a problem with fleas? Allergies? Are there any restrictions that need to be placed on your dog's activities or movements? If yes, please explain: How does your dog react to having his/her nails clipped? Does your dog have any sensitive areas on his/her body? Behavior Does your dog act afraid of any specific items or noises? If so, please explain: Are there any kinds of people your dog automatically fears or dislikes? Are there any kinds of dogs your dog automatically fears or dislikes? How does your dog react to puppies?

3 Has your dog ever: Growled at someone? What were the circumstances: Bitten someone? What were the circumstances: Does your dog have any problems in any of the following areas: (if so, please explain) Aggression: Housetraining: Barking: Digging: Jumping: Other: Has your dog ever jumped or climbed a fence? Has your dog ever growled or snapped at anyone who has taken his/her food or toys away from Him/her? What were the circumstances: Has your dog ever shared his/her food or toys with other animals? Does your dog play with any toys? If yes, what kind of toys does your dog like and what games does he/she play? Does your dog play with other dogs? Has your dog ever had any formal obedience training? If yes, when and where? What commands does your dog know? Is your dog allowed to have bedding in his room? Cot? Blanket? Soft beds? Towel? Other comments about your dog which you feel might be helpful:

4 General Information and Polices The purpose of Bed & Biscuit, Inc. is to provide a safe, fun and stimulating social environment for dogs. To ensure the safety and health of your pet and our other guests, we require all guests to comply with the following rules and regulations: AGE: All dogs must be at least 12 weeks of age or older. SEX: All dogs 6 months or older must be spayed or neutered, SHOTS: All dogs must have up-to-date vaccinations. Owners must submit written proof of DHLPP and Bordetella vaccinations. Rabies is required for puppies over 4 months of age. HEALTH: All dogs must be in good heath and must have resided in the owners home for a minimum of two weeks. Owners will certify their dog(s) are in good health and have not been ill with a communicable condition in the last 30 days. Upon admission, all dogs must be free from any condition which could potentially jeopardize other guests. Dogs that have been ill with a communicable condition in the last 30 days will require veterinarian certification of heath to be admitted or readmitted. BEHAVIOR: All dogs must be non-aggressive and not food or toy protective. Owners will certify their dogs have not harmed or shown any aggressive or threatening behavior towards any person or any other dog(s). Please remember: your pet will be spending time with other pets and the safety and health of all animals is our main concern. APPLICATION: All dogs must have a complete, up-to-date and approved application on file. FEES: Daycare rates vary by package. Since discounts are intended for dogs attending our daycare program regularly, packages must be used within 3 months. Daycare Rates Sleep Over Rates 1 Day- $25 Den- $7 + daycare rate 10 Day Package- $210 ($21 per day) Suite- $15 + daycare rate Drop-off/Pick-up Hours Monday-Friday 7am-9:30am and 3:30pm-6pm. (6:30am available by appointment). Saturday & Sunday 9am-11am and 3pm-5pm. RESERVATIONS: Required. Building is staffed according to reservations. Cancellations with less than 24 hours notice will be charged full fees.

5 Doggie Daycare and Boarding OWNER AGREEMENT I,, hereby certify 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 my dog(s) have not harmed or shown aggressive or threatening behavior towards any person or any other dog. I have read and understand the following: (initial each) 1. I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending Bed & Biscuit,Inc. 2. I further understand and agree that in admitting my dog(s), Bed & Biscuit, Inc. staff have relied on my representation that my dog(s) is/are in good health and have not harmed or shown aggressive or threatening behavior towards any person or any other dog. 3. I further understand and agree that my dog will be allowed to commingle with other dogs. I further understand the inherent risk of injury or disease. Bed & Biscuit, Inc. and their staff and volunteers, will not be liable for any problems which develop, provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising from my dog(s) attendance and participation at Bed & Biscuit, Inc. 4. I further understand and agree that any problems which develop with my dog(s) will be treated as deemed best by staff and volunteers of Bed & Biscuit, Inc. at their sole discretion, and that I assume full financial responsibility for any and all expenses involved. I certify that I have read and understand the policies of Bed & Biscuit, Inc. as set forth on the preceding pages and that I have read and understand the conditions, and statements of this agreement, including the following: RESERVATIONS: Required. Cancellations with less than 24 hours notice will be charged full fees. Date: Signature of Owner:

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